This chapter mainly focuses on the role of antivascular endothelial growth factor drugs and surgical management of retinopathy of prematurity (ROP). It is well known that ROP is a vasoproliferative retinopathy and early exposure of an immature and poorly vascularized retina to hyperoxic environment leads to the development of ROP. Laser ablation of peripheral avascular retina with laser photocoagulation is the mainstay for treatment. Surgery for ROP has good results in early cases of stage 4A ROP. As the ROP continues to worsen and reaches stage 4B and stage 5 the prognosis continues to worsen. The best way to prevent these surgical challenges is to establish effective ROP screening programs which can screen, refer, and treat ROP in time so that babies do not develop advanced ROP. There is a need for creating awareness amongst ophthalmologists, pediatricians, and parents about the blinding outcomes of ROP and ensure that no baby goes blind.