Objective To explore the risk prediction model of diabetic retinopathy (DR) in female patients with type 2 diabetes mellitus (T2DM). Methods A total of 253 female patients with confirmed T2DM were included in the study. The patients were divided into DR group and non-DR group according to whether DR occurred or not according to the results of the fundus examination. The baseline data of the two groups were compared, and multivariate logistic regression was used to analyze the case data of the two groups. ROC curves were drawn using graphpad prism 8 to analyze the predictive performance of the model. Results Multivariate logistic regression analysis showed that the duration of diabetes mellitus (DM), glycosylated hemoglobin (HbA1c), neutrophil-to-lymphocyte ratio (NLR), and pulse pressure were the main risk factors for the occurrence of DR in women. Subcutaneous fat area (SFA) was the protective factor in the development of DR for females. Construct a female DR risk prediction model Y=1/[1+e^{-(0.138X1+0.265X2+0.477X3+0.023X4-0.007X5-5.304)}], X1 refers to the course of DM, X2 refers to HbA1c, X3 refers to NLR, X4 refers to pulse pressure, X5 refers to SFA. The area under the ROC curve (AUC) of the risk prediction model was 0.806, the 95% CI was 0.752~0.860 (P<0.001), the maximum Youden index was 0.480, the best critical value was 0.335, the corresponding sensitivity was 0.798, and the specificity was 0.682. Conclusion The occurrence of DR in female T2DM patients is related to the course of DM, HbA1c, NLR, SFA, and pulse pressure. The risk prediction model of DR in female T2DM patients is feasible.