OBJECTIVE To establish the incidence and severity of retinopathy of prematurity (ROP) in an Australian population of premature infants, and define risk factors for this population. METHODS A survey of neonates born weighing less than 1501 g and/or with gestational age below 33 weeks, was undertaken at a neonatal intensive care unit in South Australia. RESULTS ROP was diagnosed in 16.0% of the 94 neonates who were screened until retinal vascularisation was complete. Threshold disease occurred in 4.2%. Logistic regression identified three significant risk factors for the development of ROP: days of mechanical ventilation, multiple birth and female sex. CONCLUSIONS The incidence of ROP was relatively low when compared with figures recently published for two large populations studied in the United States and England. This difference was due to a lower incidence of mild forms of the disease. Days of mechanical ventilation, multiple birth and female sex were independently predictive of the occurrence of ROP. As small numbers of infants with ROP are managed at individual Australian centres each year, a national ROP register is recommended to facilitate the study of the disease in this country.