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Background: Retinopathy of prematurity (ROP) is a vaso-proliferative retinal disease which can cause blindness if not diagnosed early. The various risk factors associated with ROP other than pre mature birth and low birth weight are high flow oxygen, sepsis , multiple transfusions, multiple births, respiratory distress syndrome, apnoeic episodes, intraventricular haemorrhage. Poor antenatal care, unavailability, poor access and poorly monitored neonatal care are some of the factors contributing to increase in the number of ROP cases in developing countries. Objective: To study ROP in preterm and high risk neonates in a tertiary care hospital. To assess and record changes of ROP and the associated risk factors in the study population.. To document the staging of ROP. To determine the outcome of Retinopathy of Prematurity and the different modalities of treatment used. Material & Method: This study was conducted on 262 eyes of 131 neonates over a period of 18 months. All Pre term neonates having gestational age of less than or equal to 32 weeks and birth weight less than or equal to 1500gms and other older neonates more than 32 weeks of gestation and more than 1500gms of birth weight with risk factors for developing Retinopathy of prematurity (i.e on oxygen supplementation, Respiratory distress syndrome, Sepsis, Multiple blood transfusions, Apnoeic episodes, Intraventricular haemorrhage) , admitted and referred to our institute within the study period were screened for Retinopathy of Prematurity. Neonates observed having ROP were followed up till complete regression of ROP. Results: In our study ROP was observed in 18.32 % of neonates. There was significant relation of birth weight and gestational age with retinopathy of prematurity. Also risk factors like Respiratory distress syndrome and mechanical ventilation were significantly associated with retinopathy of prematurity. The treatment requiring cases of Retinopathy of Prematurity were 6.11% i.e 8 neonates. All the treatable cases were given ROP Laser therapy while 6 neonates were also given intra- vitreal injections of bevacizumab. Conclusion: Low birth weight, Prematurity, Respiratory distress syndrome, Mechanical ventilation were the risk factors significantly associated with ROP. Prompt screening and early diagnosis of ROP can help in reducing devastating complications and thus prevent blindness.