Diabetic retinopathy (DR) is a microvascular disorder of retina due to diabetes mellitus (DM). This condition can lead to cellular and tissue damage in the retina. Moreover, natural products are widely used to prevent and treat various diseases. This study aims to evaluate the effect of buah merah extract (Pandanus conoideus Lamk.) on retinal density and apoptosis in a diabetic rat model. A total of 30 male rats (Rattus novergicus) weighing 120-150 grams were induced with diabetes using alloxan and divided into five groups, group 1 (normal control), 2 (diabetic control), 3 (diabetes + 1 ml buah merah extract), 4 (1.5 ml), and 5 (2 ml). Buah merah extract equivalent to 12 mg total carotenoids, 10 mg total tocopherols, 1.348 mg alpha-tocopherol, and 3.4 mg beta-carotene was administered for 14 days. Retina was examined using HE staining for photoreceptor and retinal ganglion cell density, and IHC Caspase-3 for apoptosis. The results showed that group 3 had photoreceptor and retinal ganglion cell densities close to normal, with photoreceptor density values of 722.52 ± 147.56 and ganglion 18.73 ± 5.61. The post-hoc test confirmed a significant protective effect of buah merah extract in group 3 (p-value 0.014). However, buah merah extract provided a protective effect on retinal cells in diabetic rat model, specifically at a dose of 1 ml. Further studies are needed to better understand the mechanism and potential therapeuetic effect of buah merah extract.