The treatment of diabetic retinopathy and subsequent visual acuity outcomes have been markedly improved by the advent of vascular endothelial growth factor (VEGF) inhibitors. Originally focused on the treatment of diabetic macular edema (DME), it is now well established that anti-VEGF therapy can have additional beneficial effects by reducing diabetic retinopathy severity and treating proliferative diabetic retinopathy (PDR). Furthermore, we now have direct comparisons regarding the efficacy of various VEGF- inhibitors in specific disease cohorts permitting informed choices of therapeutic options. Our understanding of the efficacy, timing, therapeutic response, treatment burden, pertinent clinical findings and side effects continue to expand with further analysis of prior trials and ongoing studies. In this presentation the current status of anti-VEGF therapy for DME, PDR and retinopathy severity will be discussed.