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Background: Diabetic retinopathy (DR) is implicated in blindness of diabetic patients. Early diagnosis of DR is very essential to ensure good prognosis. The role of microRNAs (miRs) as biomarker diagnostic tools in DR is not fully investigated. The present study aimed to find the relation between serum relative expression of microRNAs (miR-146a, miR-21 and miR-34a) and severity of DR and to what extent their expression pattern can be used as either diagnostic or prognostic., Methods: Eighty type 2 diabetic patients were classified according to severity of DR into normal, mild, moderate, severe non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Serum relative expressions of miRNAs were evaluated by qPCR and statistically analysed in each stage using Analysis of Variance (ANOVA) followed by Tuckey-Kramer post-test., Results: Serum relative expressions of miR-146a and miR-21 were increased with increased severity of DR. miR-34a decreased with the severity of DR. The expression pattern in each group in relation to normal fundus group could be diagnostic and prognostic where miR-146a was only increased in mild group and continued with the severity. In moderate group miR-21 start to increase along with slight decrease in miR-34a. In severe NPDR group along with highly increased levels of both miR-146a and miR-21, a marked decrease in miR-34a. In PDR group miR-34a was almost diminished along with very high levels of both miR-146a and miR-21., Conclusions: miRs (-146a,-21 and-34a) are promising biomarkers in DR and can help to avoid disease progression., Competing Interests: Conflicts of interest None of the authors has any conflicts of interest regarding this study., (Published by Elsevier B.V.)