Aims To examine the association of Angiotensin I converting enzyme 2 (ACE2) gene polymorphisms and retinopathy in a Chinese type 2 diabetes mellitus (T2DM) cohort. Methods A total of 743 T2DM participants were involved in this study including 408 female and 335 male cases. Female cases were divided into two groups: diabetes without retinopathy (DNR group, n ¼ 171) and with retinopathy (DR group, n ¼ 237), the latter was further subclassified into nonproliferative DR (NPDR group, n ¼ 121) and proliferative DR (PDR group, n ¼ 116). Male cases were assigned to DNR group (n ¼ 153) and DR group (n ¼ 182) which was further grouped into NPDR group (n ¼ 86) and PDR group (n ¼ 96). Two single nucleotide polymorphisms (SNPs; rs2074192 and rs714205) in ACE2 gene were genotyped. Results In female cases, the frequency of genotypes TT in rs2074192 and CC in rs714205 were higher in DR and PDR group than in DNR group (Po0.05). The frequency of alleles T in SNP rs2074192 and C in SNP rs714205 was higher in DR group (Po0.05) and PDR group (Po0.05) than in DNR group. The frequency of allele T in SNP rs2074192 was higher in PDR group (P ¼ 0.04) than in NPDR group. The frequency of haplotype TC and CG was higher in DR and PDR groups, respectively (Po0.05). No positive results were found in male cases. Conclusions Our results revealed that SNPs rs2074192 and rs714205 in ACE2 gene were associated with the susceptibility of DR and PDR.