BACKGROUNDWith improved neonatal care and better survival rate of premature babies, incidence of Retinopathy of Prematurity (ROP) in our country is on the increasing trend. As we know there are many foetal and maternal risk factors influencing the development of ROP, not all preterm babies develop ROP. MATERIALS AND METHODSThe aim of this study is to determine the effect of maternal pre-eclampsia on development and severity of ROP among preterm babies delivered in our Govt. Rajaji Hospital; 200 babies with birth weight less than 1750 grams and less than 34 weeks of gestation were taken up for this prospective observational study. Babies of mothers with gestational hypertension, eclampsia, chronic hypertension, preeclampsia superimposed on chronic hypertension, babies with congenital anomalies and who expired before completion of ROP screening were excluded. RESULTSAmong 140 babies of normotensive mothers and 60 babies of preeclampsia mothers, 43.6% and 45% had developed any stage of ROP respectively. Incidence of severe ROP in babies of normotensive mothers was 13.6%, whereas it was 3.3% in babies of preeclampsia mothers. Statistical analysis done using student's t-test, "P" value was found to be < 0.05. CONCLUSIONWe conclude that maternal preeclampsia is a protective factor for the development of severe ROP. KEYWORDS BACKGROUNDRetinopathy of Prematurity (ROP) is a disease characterised by abnormalities in the vascular development of retina in premature infants. With improved neonatal care and better survival rate of premature babies, incidence of ROP in our country is on the increasing trend. ROP incidence increases 1 with decreasing Gestational Age (GA) and Birth Weight (BW); however, not in all preterm babies. So, there might be other foetal and/or maternal risk factors influencing the development of ROP. These factors may protect or increase the probability of development of ROP.