Objective: To assess the 10-year incidence of retinal vein occlusion (RVO) and its predictors in an older population. Methods: The Blue Mountains Eye Study examined 3654 residents aged 49 years and older (82.4% response) from 1992 to 1994, reexamined 2335 residents (75.1% of survivors) from 1997 to 1999, and reexamined 1952 residents (75.6% of survivors) from 2002 to 2004. Incident RVO was assessed from stereoscopic retinal photographs. Kaplan-Meier cumulative 10-year incidence was calculated. Results: After excluding 47 residents with RVO at baseline and 171 residents with no photographs at either followup examination, 2346 residents were considered at risk of developing RVO. The cumulative 10-year incidence of RVO was 1.6%. Age was significantly associated with the incidence of RVO (P=.03, Mantel-Haenszel χ2 test for trend). Factors predicting the incidence of RVO included mean arterial blood pressure (age-adjusted odds ratio [OR], 1.41 per 10-mm Hg increase), ocular perfusion pressure (OR, 1.71 per 10-mm Hg increase), obesity (OR, 2.16), and presence of retinal arteriolar wall signs (focal narrowing: OR, 3.37; arteriovenous nicking: OR, 4.09; and opacification: OR, 4.89). Conclusions: Older age (≥70 years), increasing mean arterial blood pressure, and atherosclerotic retinal vessel signs were significant predictors of incident RVO.