OBJECTIVE:: Retinopathy of prematurity (ROP) is a complication seen in many very low birth weight infants. Severe ROP has been called a "marker" for severe disability. The purpose of this study was to evaluate the occurrence and severity of ROP among infants ≤1250 g birth weight treated in the Special Care Nursery at Women & Infants' Hospital over a period of 7 years from 1994 to 2000. STUDY DESIGN:: This was a retrospective review of ROP data combined with neonatal follow-up data. Of the 1002 infants born with birth weights <1250 g, ophthalmologic data were available for 739 of 839 survivors. Analysis of variance and χ along with logistic regression were used to analyze outcomes. RESULTS:: An increase in the overall occurrence of ROP was identified (40% to 54% linear trend, p=0.007). The occurrence of threshold ROP ranged from 2% to 5% (NS). Infants at greatest risk of ROP were those micropremies with birth weights <750 g (p<0.001). CONCLUSION:: Severe ROP continues to be a significant morbidity among infants <750 g.