The purpose of this study was to evaluate the pattern of retinal diseases as seen at a teaching and tertiary eye care center in Addis Ababa. In a descriptive, cross-sectional study, all consecutive patients seen at the retina clinic of Menelik II Hospital during a 19 months period (January 2000 to August 2001) were included in this series. Pertinent demographic and clinical data were recorded for all patients. A total of 1390 new patients with retinal diseases were seen at the retina clinic during the study period, accounting for 12.5% of the total outpatient population of the eye department. The male to female ratio was 1.8 : 1. The mean age was 45.2 years +/- 17.3 years (range 2 months to 92 years) and median of 44.5 years. Two hundred and twenty-four (16.1%) patients were bilaterally blind, 465 (33.5%) patients were unilaterally blind, 280 (20.1%) patients had bilateral visual impairment and 195 (14.0%) patients had unilateral visual impairment, while 213 (15.3%) patients had normal vision. Retinal detachment was the commonest cause of both bilateral (54.9%) and unilateral blindness (41.2%), while diabetic retinopathy and myopia were the leading causes of bilateral visual impairment accounting for 36.8% and 28.2% respectively. Retinal vascular diseases accounted for the largest group of patients (38.1%) of which diabetic retinopathy accounted for 75.1%. Retinal detachment was the second largest group of diseases, accounting for 24.5% of the total. The proportion of patients with age-related macular degeneration was only 2.7%. Most of the patients presented with advanced disease, which required vitreo-retinal surgery. There is a need to improve on the early diagnosis and early referral of retinal diseases at primary and secondary care levels. Selected tertiary care centers should develop capacity to provide laser and vitreo-retinal surgery. The introduction of posterior vitrectomy in Ethiopia is long overdue.