To study the incidence and risk factors of Retinopathy of prematurity in extremely low birth weight babies in a tertiary neonatal care unit in northern India. A prospective cohort study of all neonates born during January 1, 2015 to December 31, 2015, with birth weight less than 1000 grams. Demographic details, risk factors and incidence of ROP were studied. Sixty babies were enrolled for the study with mean birth weight of 892.983±112.933 (560 to 1000) grams and mean gestation age of 29.47±2.258 (25-35) weeks. The incidence of ROP in this cohort was 50% (30 infants), out of which 23% (7 infants) required treatment (laser photocoagulation). The statistical analysis of risk factors on univariate analysis revealed significant association for oxygen exposure, apnoea, surfactant use, anaemia, blood transfusion, intraventricular haemorrhage, sepsis and antibiotic use. On multivariate logistic regression analysis anemia and oxygen exposure > week were found to be independent risk factors for development of ROP. The incidence of ROP was although high in this exclusive cohort of babies born <1000g but there is substantial decrease in incidence as compared to that reported in earlier studies. Gestational age <30 wks, being appropriate for gestation rather than small for gestation, anemia and oxygen exposure>1 week were found to be independent risk factors for development of ROP in this cohort.