Objective: Retinopathy of prematurity (ROP) poses a significant challenge in the area of neonatal care, characterized by an aberrant retinal vasculature, often culminating in irreversible vision loss in childhood. Methodology: This prospective observational study was conducted at UPUMS Saifaiafter obtaining ethical clearance in the UPUMS, Saifai, Uttar Pradesh, India. The study spanned one year and enrolled a total of 250 neonates admitted to the Neonatal Intensive Care Unit (NICU) between March 2023 and March 2024. Results: Of the 20 infants weighing less than 1000 grams, 11 developed stage 1 or 2 ROP, highlighting a significant risk for ROP among extremely low-birth-weight infants. Among the 79 infants weighing between 1000 and 1500 grams, 26 developed ROP, with stage 2 being the most common, suggesting that infants in this weight category have a moderate risk of ROP development, with many progressing to advanced stages. Out of the 98 infants weighing between 1500 and 2000 grams, 14 developed ROP, with the majority of cases being stage 1 or 2, indicating that even among infants with slightly higher birth weights, there is still a notable risk of ROP development. Interestingly, out of the 53 infants weighing more than 2000 grams, only 5 developed ROP, all of which were limited to stages 1 or 2, suggesting that infants in this category have the lowest risk of developing ROP due to their higher birth weights. We examined a total of 250 infants across all weight categories, and 56 of them developed ROP. Stage 1 and 2 ROP were most common, indicating that the condition is more prevalent in its milder forms. Conclusion: Lower birth weight is associated with a higher probability of ROP occurrence, emphasizing the significance of monitoring and managing ROP in extremely low-birth-weight infants.  Categories: Pediatrics, Ophthalmology