Promoting growth in very low birth weight infants (VLBW) is not astraight forward endeavor. This is one of the greatest clinical challenges confronting those who mange the care of these infants in the neonatal intensive care unit (NICU). Objectives :-To detect different factors affecting growth patterns of very low birth weight preterm infants, to relate growth velocity to different nutritional practices, to relate growth velocity to several common majormorbidities including late-onest sepsis, Necrotizing enterocolitis (NEC), and chronic lung disease and to compare growth velocity in infants who are small-for- gestational age (SGA) with infants who are appropriate-forgestationalage (AGA). Patient and Methods :- Our study is A prospective study including 75 preterm infants weighing between 1050-1500 gram, who were Admitted to the Neonatal intensive care unit’s (NICU) – Cairo University hospitals at 24 hours at Age or less. Case were subjected to thorough history taking, through general examination, Anthropometric measurements, Nutritive data and Drugs given to the baby that may affect his weight gain during their hospital stayResults :- In our study the average daily weight gain after regain birthweight is 13.44 gm/kg/day, average increments in length and headcircumference are 0.82 cm/week and 0.69cm/week respectively. Thisgrowth rates are less than the targeted intrauterine growth rates during 3rd Trimester. In our study major morbidity e.g. ( Neonatal Sepsis, CLD ) markedly impede growth rates, Also SGA gain weight faster than their comparable AGA. Conclusion : In order to increase growth patterns in our Neonatal intensive care units we need early management of major morbidities, Also we need Another large, multi-centre studies, To access growth rates and factors affecting growth patterns especially nutritional factors.