Summary Retinopathy of prematurity (ROP) has been recognised as an important cause of childhood blindness. It is now a treatable disease with a reduced incidence of resulting blindness. The incidence of ROP in older premature babies has declined and a new pattern of ROP has emerged attributed to increased survival of very low birth weight infants. This may require a different management approach with treatment at an earlier stage. Here we give an overview of the natural history of ROP, terminology, screening and diagnosis. We also describe the examination and treatment of the infant with ROP. While significant reductions in the disease have occurred, further research is required to fully understand and prevent the disease.