Abstract Background: Incomplete vascularization of the retina in preterm neonates causes the sight-threatening condition known as retinopathy of prematurity (ROP), which is caused by pathological angiogenesis. Despite current therapy approaches, ROP represents a substantial cause of disability in children. Aim of Study: To determine the demographics and epide-miology of retinopathy of prematurity for infants at risk in three selected Egyptian governorates: Gharbia, Kafr El-Shiekh and Al-Buhaira. Also, to study the possible factors that increase the chance of developing ROP and the requirements for intervention. Patients and Methods: A prospective cohort study enrolled 300 preterm babies from 3 different governorates (Gharbia, Kafr El-Shiekh and Al-Buhaira) for ROP screening and iden-tification of risk factors. Infants born under 1500g birth weight (BW) or at less than 32 weeks gestational age (GA) were included, as were infants with a GA of more than 32 weeks and/or a BW of more than 1500g who were clinically unstable. Demographic data and possible risk factors were collected. Results: The mean BW and GA of the studied preterm babies were 1484.05±316.71 & 31.9±2.03 weeks, respectively. The study revealed an 80% overall incidence of ROP. Severe ROP was detected in 22.9% of all ROP cases. Lower BW and GA, apnea, RBCs infusion and broncho-pulmonary dysplasia were the most relevant risk factors. Conclusion: ROP Screening is mandatory to decrease blindness and persistent visual impairments. Older and larger infants can develop ROP and sight threatening ROP compli-cations if they have co-morbidities.