The purpose of this study was to evaluate the correlation of expression of phosphorylated methyl-CpG binding protein 2-Ser421 (MeCP2-S421) and VEGF in the membranes of patients with PDR. We examined the expression of phospho-MeCP2-S80, S421, VEGF and PEDF in surgically excised PDR membranes from 33 patients with diabetes, and idiopathic epiretinal membranes from 11 patients without diabetes, using immunohistochemistry and western blot. The colocalization of MeCP2-S421 with VEGF, PEDF, CD31, GFAP and αSMA was revealed by fluorescent double labeling. The effect of CoCl2 and knock down MeCP2 using specific siRNA on the expression of MeCP2 and VEGF were analyzed in HUCAC cells by Western blot. We found that phospho-MeCP2-S421 was significantly increased in the membranes from the patients with PDR compared with the specimens from patients without diabetes (P < 0.01). The expression of phospho-MeCP2-S421 was much stronger than that of phospho-MeCP2-S80 in the PDR membranes. Double labeling showed that the high phospho-MeCP2-S421 expression was associated with strong expression of VEGF, but not PEDF. Further, phospho-MeCP2-S421 and VEGF were increased by the stimulation of CoCl2 and knock down MeCP2 inhibited the expression of VEGF. Our result suggests that phospho-MeCP2-S421 might involve in the pathogenesis of PDR.