Our paper investigated the effect of berberine on the diabetic retinopathy (DR) in db/db transgenic mice and explored its possible mechanisms. During chronic intragastric administration for ten weeks, berberine could decrease the levels of fasting blood glucose, TC and TG without hepatotoxicity. Moreover, berberine could protect the retinal morphology against the hyperglycemic insults and decrease glycogen accumulation, the contents of TNF-α and IL-1β in the retinas, as demonstrated by HE staining, PAS staining and ELISA kits, respectively. Immunofluorescence assay revealed that the protein expression of vascular endothelial growth factor (VEGF), VEGF receptor 2, hypoxia-inducible factor-1α(HIF-1α), and nuclear factor-κ B (NF-κB) p65 was upregulated in db/db retinas compared with wild type ones, whereas berberine treatment could suppress their expression. Berberine prevent DR development through modulating the glucolipid metabolism and inhibiting the HIF-1α /VEGF/NF-κ B pathway, suggesting that berberine maybe a potential agent for the treatment of DR.