AIM: To analyze the findings of retinopathy of prematurity (ROP) exam in Tianjin, and study the impact of pulmonary surfactant Curosurf and nasal continuous positive airway pressure (NCPAP) in ROP. METHODS: A multicenter retrospective review. 2894 preterm infants (1592 males, 1302 females) from several hospitals in Tianjin were screened from January 2009 to December 2013. Demographic information, ophthalmic outcomes and possible systemic risk factors were recorded. Gestation age, birth weight, oxygen supplementation, Curosurf and NCPAP were used to estimate risk factors for ROP. RESULTS: ROP was found in 448 eyes of 224 patients (7.7%). Among which, severe ROP developed in 98 eyes of 49 patients (21.9%). There was significant statistical difference in RDS, NCPAP, and Curosurf usage between control and ROP groups (P=0.000). Multiple logistic regression analyses of ROP indicated that lower birth weight, younger gestational age, and oxygen supplementation were the risk factors leading to ROP. As the usage rate of Curosurf and NCPAP increased year by year, the usage of oxygen supplementation gradually decreased, the incidence of ROP was also on the decline. CONCLUSION: Low birth weight, young gestational age and oxygen supplementation are associated with ROP. The use of Curosurf and NCPAP may be the factor that reduces the occurrence of ROP.