Background With advance in perinatal care, knowledge, experience and technology: The outcome of the extreme preterm infants (<30 weeks gestation, and <1000 g has been upturning; King Faisal Sp. Hospital, we are lacking data for parents counseling, and bench mark for the unit. Method Retrospective study to evaluate the short outcome experience results for extreme preterm infants whom inborn or transferred to our unit, within 2 weeks after birth, over 12 years. Infants with multiple congenital anomalies, or transferred with complications excluded. SPSS version 20 to analyze the data collected in case report form (CRF). Several variables studied, the mortality rate and hospital stay were calculated. Results 324 files studied 92 (28%) met inclusion criteria, 232 excluded 71%, 92 infants, (50% each males and females); All developed RDS (100) Mortality (10/92) 11%; ROP(24/92) 16%; NEC(6/92)7%; SEPSIS(40/92) 43% G-ve was 32%, G+ ve 23%; PNUMONIA(5/92)5%; PVL(3/92) 3%; BPD(16/92) 17%; IVH(17/92) 18%; MENINGITIES(2/92) 2%; PDA(85/92) 92%, 64% self closed, 9% Indomethacin, 6% ibuprofen, 21% required surgery; length of stay (LOS) mean of 64 days. Conclusion and recommendation Results comparable to results reported by National Institute of Child Health and Human Development (NICHHD). Extreme preterm infants should be delivered or transferred within one week to a tertiary care facilities for best outcome.