Objective: To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema (DME). Methods: A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group, with 25 cases in each group, using a random number table method. The observation group received intravitreal injection of faricimab, while the control group received intravitreal injection of conbercept. Both groups adopted a loading phase plus maintenance phase treatment regimen. The best-corrected visual acuity (BCVA, expressed in logMAR) and central subfield thickness (CST) of the two groups were compared before treatment and at 1, 3, and 6 months after treatment, and the incidence of adverse events during treatment was recorded. Results: The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment (both p < 0.05). The CST in the observation group was smaller than that in the control group at 1, 3, and 6 months after treatment (all p < 0.05). There was no statistically significant difference in the overall incidence of adverse events between the two groups (χ² = 0.189, p = 0.663). Conclusion: Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME, with good safety profiles. However, faricimab demonstrates superior efficacy in the medium to long term (3 and 6 months) compared to conbercept, making it more suitable for long-term treatment of patients with DME.