Microalbuminuria and retinopathy was studied in a non-proteinuric diabetic population of Cameroon. Patients were enrolled on a consecutive basis in two referral hospitals in Yaoundé. Retinopathy was evaluated by direct ophthalmoscopy and biomicroscopy, and controlled by mydriatic fundus photography. Detection of microalbuminuria was carried out on an overnight urine sample using Micral II test (Boehringer Mannheim). Anthropometric and blood pressure measurements were done using validated methods. In 64 non-proteinuric diabetic patients (9 IDDM and 55 NIDDM) aged 19-70 years with known duration of diabetes of 1-23 years, the prevalence of retinopathy was 37.5%. Microalbuminuria was detected in 53.1% of patients. Microalbuminuria correlated with duration of diabetes, and blood pressure, retinopathy was positively correlated with age, and blood pressure. Retinopathy was not significantly associated with the known duration of diabetes. Retinopathy was found to be independently associated with microalbuminuria (P < 0.001) and microalbuminuria appeared to be a sensitive marker of retinopathy. The prevalence of retinopathy and microalbuminuria in this population was high. Microalbuminuria and non-proliferative retinopathy are independently associated, and are both associated with increased blood pressure levels in the study population. As shown in previous studies microalbuminuria may also be a sensitive marker of early diabetic retinopathy in African diabetic patients.