AIM: To audit the prevalence of retinopathy of prematurity (ROP) in a level 2 status neonatal unit. METHODS: Data were collected prospectively over 9 years from September 1989 to September 1998. Preterm infants were examined according to the Royal College of Ophthalmologists' guidelines and retinopathy graded following the International Classification of ROP. ROP 3-5 was analysed using logistic regression in relation to time, and to gestational age and birth weight. RESULTS: 383 babies were examined. Mean gestational age fell over the 9 year period (p=0.051) as did mean birth weight (p<0.001). There was a decrease in the number of infants with ROP grades 3-5 over the 9 years (p=0.045 and, when adjusted for gestational age and birth weight, the decrease in ROP 3-5 was significant (p=0.03). CONCLUSIONS: This study found a significant reduction in the incidence of ROP during the 9 years of the study period, despite a decrease in mean gestational age of and birth weight. The reduced incidence of ROP is attributed to improvements in ventilation techniques and overall care of the neonate, in particular the use of prenatal steroids and surfactant.