Aim: To evaluate the correlation of glycosylated hemoglobin (HbA1c) levels with the severity of diabetic retinopathy in patients with type 2 diabetes mellitus at a tertiary care hospital. Materials and Methods: This cross-sectional descriptive observational study was conducted in the Department of Ophthalmology after obtaining approval from the institutional ethics committee. A total of 125 participants with type 2 diabetes mellitus and retinopathy changes in the fundus were included. Patients with systemic diseases causing retinal pathology, hazy ocular media, gestational diabetes, and juvenile diabetes were excluded. A detailed ophthalmic examination was performed, including fundus evaluation with indirect ophthalmoscopy and slit-lamp biomicroscopy. HbA1c levels were measured using the Daytona auto analyzer and expressed in percentage. Results: The study included 57.60% male (72) and 42.40% female (53) participants, with a mean age of 56.40 years and a mean diabetes duration of 8.20 years. The mean HbA1c level was 9.75%. Moderate NPDR was the most common retinopathy stage (28.80%), followed by mild NPDR (22.40%), early PDR (20.00%), severe NPDR (16.00%), and high-risk PDR (12.80%). HbA1c levels were significantly associated with retinopathy severity, showing a progressive increase from mild NPDR (8.20%) to high-risk PDR (12.30%). Conclusion: Glycosylated hemoglobin (HbA1c) levels show a significant correlation with the severity of diabetic retinopathy, with higher levels observed in advanced stages. Poor metabolic control and prolonged diabetes duration are strong predictors of retinopathy severity. These findings emphasize the importance of maintaining optimal glycemic control and regular screening to prevent the progression of diabetic retinopathy.