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Children born with very low birth weight perform poorly on executive function and attention measures. Any difficulties with sustained attention may underpin impairments in performance on tasks measuring higher order cognitive control. Previous sustained attention research in very low birth weight cohorts has used tasks that involve arousing stimuli, potentially spoiling the measure of sustained attention. The aim of this study was to compare the performance of very low birth weight and normal birth weight children on a well-controlled task of sustained attention. The Fixed and Random versions of the Sustained Attention to Response Task were given to 17 very low birth weight and 18 normal birth weight children. The very low birth weight group performed the Fixed and Random Sustained Attention to Response Tasks in a similar manner as the normal birth weight group on all measures except for the omission error and Slow Frequency Area under the Spectra variables on the Fixed Sustained Attention to Response Task. These measures index lapses in sustained attention that may be underpinned by declining arousal. The very low birth weight group showed no response inhibition deficits. Omission errors and slow-timescale response-time variability on predictable tasks may thus present sensitive indices of difficulties with sustained attention and arousal associated with premature birth and low birth weight.