CVD prevention does not only mean effective fight against the existing cardiovascular risk factors, but also against their complications, including micro- and macrovascular ones. In relation to obesity, prediabetes and diabetes, we recognize a number of potential dangerous non-cardiovascular complications, such as neuropathy, nephropathy and retinopathy. The latter’s prevalence is even 30-40% and may appear in as many as 15% of patients with prediabetes. Not treated well might result in necessity of eye surgery or even vision loss. Fenofibrate has had a long history of evidence suggesting preventive role in primary and especially secondary prevention of retinopathy, what has been being investigated since the FIELD trial 19 years ago. In this Position Paper we have reviewed the current stage of knowledge on possible mechanisms, by which fenofibrate may contribute to retinopathy prevention, available data on safety and efficacy, to finally recommend administrating fenofibrate in prevention of this dangerous diabetic complication.