The rate of ROP in middle income countries is so significant that some are referring to this as a third epidemic of ROP. Increased survival of premature infants in Egypt in the past few years due to advances in the antenatal and neonatal care resulted in a population of infants at high risk of developing retinopathy of prematurity. We are aiming to determine the prevalence and possible risk factors of ROP in a unit-based approach in Almaza hospital, neonatal intensive care unit in Cairo, Egypt.