Introduction: Retinopathy of prematurity (ROP) chiefly affects preterm infants. With the increased survival of extremely preterm infants, the number of infants with severe ROP has also increased.Objective: To assess the incidence, associated factors and outcome of ROP in neonates born at less than 34 weeks of gestation and/or less than 1.5 kg birth weight in Sri Jayawardenepura General Hospital Method: A prospective, descriptive, observational study was conducted in neonates born from 01/01/2014 to 31/12/2014, who were less than 34 weeks of gestation and/or less than 1.5 kg birth weight. Data was collected from patient records. Incidence estimates were given using descriptive statistics. For bivariate analysis (where associated factors were considered), the Chi Square test was applied to assess significant associations. The level of significance was 0.05. Results:Of 126 neonates, 113 were included in study as 11 met exclusion criteria and 2 dropped out during follow up. Twenty eight (24.8%) neonates had ROP of whom 12 (42.9%) needed treatment. Study revealed that, earlier the gestation and lower the birth weight, ROP was more commonly observed. Patent ductus arteriosus (PDA) (p=0.006), sepsis (p=0.024), invasive ventilation for 7 or more days (p=0.0001) and supplementary oxygen for more than 7 days (p=0.0001) were significantly associated with development of ROP. ___________________________________________

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