Background  Retinopathy of prematurity (ROP) is the most frequent problem which causes blindness in preterm babies. In our study we evaluate the frequency of retinopathy, the risk factors, and their effects on disease development in premature newborns admitted to our neonatal intensive care unit (NICU). Methods  A total of 139 premature infants with gestational ages less than 34 weeks followed in our NICU between January 1, 2008 and January 1, 2011. The infants were divided into two groups as group 1 (no ROP/mild ROP) and as group 2 (severe ROP). Results  The demographics of 139 patients were as follows: 79 (56.83%) were female and 60 (43.17%) were male. Overall, 104 (74.8%) patients were found to have no or mild ROP and 35 (25.2%) had severe ROP. Among the patients in the severe ROP group, 25 of them had plus disease. With logistic regression analysis, lower gestational age (odds ratio [OR]: 4.1, confidence interval [CI]: 1.9–9.2), the central catheter usage (OR: 13.4, CI: 1.2–146.6), hypotension (OR: 7.5, CI: 1.1–49.6), perinatal asphyxia (OR: 261.3, CI: 8.8–7725.4), apnea (OR: 18.1, CI: 1.6–202.6), and high FiO 2 (OR: 1.2 CI: 1.0–1.5) were found to be related to severe ROP. Conclusion  Among the preterms with very low body weight included in our study, we found that the frequency of severe ROP requiring treatment was low. The most important factors related to severe ROP were found to be low gestational age and birth weight. Being aware of the risk factors related to severe ROP in addition to screening every preterm infant carrying these risk factors is extremely important for the early diagnosis and treatment to prevent blindness due to severe retinopathy.