Purpose. To analyze the incidence, structure and methods of treatment of active retinopathy of prematurity (ROP) in a modern hightech perinatal center by specialists from the federal ophthalmology clinic.Material and methods. The results of ophthalmological monitoring of 979 premature babies were analyzed. The children’s body weight at birth were 460–2200 g. The gestational age of the children was 22–36 weeks. The children were nursed in the perinatal center “Kaluga Regional Clinical Hospital” from 2021 to 2023. Indications for the treatment were the identification of the 2nd and 3rd stages of active ROP with an unfavorable course, aggressive posterior ROP and ROP of the 1st zone.Results. For the analyzed period, active ROP was registered in 125 children (12.77%), the aggressive posterior ROP was registered in 4 (0.4%) cases. In the structure of morbidity, ROP with a favorable course accounted for 72% of cases (90 children). The proportion of the 2nd and 3rd stages of ROP with an unfavorable course, subject to treatment was 2.4% and 22.4%, respectively, and aggressive posterior ROP was 3.2%. Treatment of active ROP with an unfavorable course was required in 28% of cases. In 2021, among the used treatment methods, the leading place belonged to laser coagulation of the retina — 72.2%. The technique of intravitreal injections of an angiogenesis inhibitor was used in 2022 in 46.2% of cases, and in 2023 it reached 100%. By 2023, the effectiveness of the treatment with achieving regression of ROP was 100% of cases.Conclusion. Modern high-tech capabilities for providing care to premature infants in Perinatal Centers, combined with the use of advanced technologies from specialized ophthalmological centers, allow for timely high-tech treatment of active ROP, which ensures that the incidence of severe, disabling forms of the disease is minimized.