The CRYO-ROP study confirmed the success of treatment for ROP and made screening mandatory. National based screening has been influenced by the varied incidence of disease in developed and developing countries. Most ophthalmologists in developed countries screen infants born between 1000 and 1500 g and between 28 and 31 weeks gestation post menstrual age. The 1984 classification has been updated to highlight the importance of plus disease. The ETROP study findings have resulted in earlier treatment and elevated the importance of screening. Measures such as nesting may help to reduce infant distress during examination. It is important for neonatal units to have an agreed policy on screening and both neonatologist and neonatal nurses have an invaluable role. Diagnostic retinal imaging and telemedicine may have an increasing role in future screening. Timely and accurate screening is the most important first step as earlier treatment results in improved visual prognosis.