This narrative review explores the revolutionary impact of smartphone-based artificial intelligence (AI) in diabetic retinopathy (DR) diagnosis in third-world countries. Leveraging the widespread availability of smartphones and advanced AI algorithms, this technology offers promising solutions to overcome challenges faced by resource-limited healthcare systems. We discuss the benefits of smartphone-based AI, such as increased access to retinal screening, cost-effectiveness, timely detection, and enhanced patient engagement. Addressing challenges like image quality standardization, validation, ethical considerations, and expertise is essential for successful implementation. Smartphone-based AI has implications for healthcare delivery, including strengthened primary care, patient-centric care, and improved public health strategies. Future opportunities lie in advancements in AI algorithms, integration with wearable devices, collaborations with healthcare systems and NGOs, AI-powered disease monitoring, longitudinal data analysis, and research and development collaborations. By embracing innovation and overcoming barriers, smartphone-based AI can pave the way for a brighter future in diabetic retinopathy management and eye care delivery for all.Â