Introduction: The authors studied the factors associated with the low accessibility of diabetic retinopathy care services in Cotonou in 2022.Study method: This was a cross-sectional and descriptive observational study. It included professional diabetic patients and healthcare professionals. Data was collected using digital and face-to-face questionnaires. The analysis was carried out using Epi Info software.Results: A total of 78 diabetics participated in the survey. The average age of the patients was 56.80 ±1.90 years. The sex ratio was 0.95. The average annual cost of diabetes treatment was 217,586.22 ± 92,618 FCFA with extremes of 30,000 and 3,000,000 FCFA. Diabetic retinopathy care services were located more than 10 km from the place of residence for 53.85% of patients. Services are available in few places and for few patients in 51.16% of cases. Patients with personal means of transportation represented 39.74% of the study population. The management of DR was provided by ophthalmologists in 55.81% according to the health professionals interviewed. The main factors associated with low accessibility to diabetic retinopathy management services were low level of education, the overall annual cost of diabetes management and diabetic retinopathy.Conclusion: This study highlights the major impact of the level of education, the costs of managing diabetes and diabetic retinopathy , as well as adherence to treatment, on the accessibility of patients to treatment services. in charge of this complication in Cotonou