Background: Refractive errors are common eye disorders affecting people of all age groups worldwide.Aim: To determine the prevalence and determinants of refractive errors among patients attending a rural-based optometry clinic from January 2018 to December 2019.Setting: The study was conducted at Sekororo District Hospital in Mopani District of Limpopo Province, South Africa.Methods: A retrospective cross-sectional study comprising two stratified random samples (2018 and 2019) was conducted based on the clinical records of patients who consulted the clinic. Data were analysed with Statistics or Data Analysis software, STATA ed. 15. Determinants of refractive errors were identified using regression analysis and reported as odds ratios with 95% confidence intervals (CI).Results: In the 2018 sample, the prevalence of myopia, hyperopia and astigmatism in the right eyes was 10% (95% CI: 7.0–14.2), 7.5% (95% CI: 4.5–1.3) and 43.4% (95% CI: 37.6–49.3), respectively. Left eyes had myopia 16.1% (95% CI: 12.2–21.0), hyperopia 7.5% (95% CI: 4.5–1.3) and astigmatism 40.1% (95% CI: 34.5–46.0). For the 2019 sample, the prevalence of myopia in right eyes was 13.3% (95% CI: 9.5–18.3), hyperopia 3.8% (95% CI: 2.0–7.3) and astigmatism 33.8% (95% CI: 28.0–40.1). Left eyes had myopia 17.5% (95% CI: 13.1–23.0), hyperopia 8.1% (95% CI: 5.2–12.4) and astigmatism 26.9% (95% CI: 21.6–33.0).Conclusion: Across the samples (2018 and 2019) and to laterality (right and left eyes), myopia prevalence ranged from 10% to 17.5% while hyperopia ranged from 3.8% to 8.1%. Astigmatism was most prevalent (ranging from 26.9% to 43.4%).Contribution: This article provides useful information about the prevalence of REs in the district hospital setting. The Department of Health Authority may use the results for policy decisions.