Objective To evaluate the sensitivity and specificity of noncontact fundus imaging based onsmartphone for diabetic retinopathy（DR）screening in urban primary medical institution. Methods We conducteda prospective and comparative study. Participants with diabetes were recruited to conduct fundus screening bysmartphone ⁃ based noncontact fundus imaging and binocular indirect ophthalmoscope（BIO）after mydriasis fromApril 1，2021，to June 31st in People′s Hospital of Xinjin District of Chengdu. With the results of BIO as a refer⁃ence standard，the sensitivity and specificity of smartphone ⁃ based noncontact fundus imaging to screen DR wereevaluated. Results A total of 143 patients of 276 eyes were recruited. Based on the diagnostic result of BIO，theoverall sensitivity and specificity of smartphone noncontact fundus imaging in the diagnosis of DR were 84.1% and94.2%（kappa = 0.79），respectively；the sensitivity and specificity for mild/moderate NPDR were 79.2% and 94.9%（kappa = 0.73），respectively；Both the sensitivity and specificity of VTDR were 100%（kappa = 1）. Conclusion Noncontact fundus imaging based on smartphone is an effective method for DR screening with high sensitivity andspecificity. As a low ⁃ cost alternative to conventional DR screening，it may help to improve the coverage of DRscreening in areas with relatively poor medical conditions.