Retinopathy of prematurity (ROP) is a severe complication of preterm birth. Criteria for ROP-Screening differ between countries as well as between units in Switzerland and usually include patients of less than 31-32 weeks of gestational age (GA) and/or a birthweight (BW) of less than 1250-1500g. Our aim was to evaluate the incidence of ROP in Switzerland and to assess if it is possible to change screening criteria so that fewer patients are screened without missing patients at risk. Conclusions: The rate of ROP-treatment in Switzerland during the observation period was very low (1.2% for children born below 32 weeks GA, 0.1% in infants born 28-32 weeks). It may be possible to optimize existing screening criteria based on risk factor analysis and subgroup analysis. We recommend a prospective setup to test the possibility of ROP screening reduction and subgroup definition.