AIM: To report the changes in detection rate and characteristics of retinopathy of prematurity (ROP) in infants, during a 12-year period in Northwest China. METHODS: The medical records of infants were retrospectively collected and reviewed using an established clinical database. The detection rate and severity of ROP were compared between two consecutive periods (P1: 2008-2013, P2: 2014-2019). Gender, gestational age (GA), birth weight (BW), multiple births, delivery pattern, and postmenstrual age of the first fundus screen were analyzed in all visiting infants. RESULTS: During the 12-year study period, 7832 infants were initially included; among them, 1266 (16.16%) were diagnosed with ROP, 441 of whom (5.63%) developed severe ROP. Throughout the study period, the total number of infants being screened showed a trend of slight fluctuation after a rapid increase; however, an annual increase was observed in the number of infants diagnosed with ROP and severe ROP. The proportion of each stage at the first screening of infants with ROP was stable. The detection rate of ROP increased from 2.33% in 2008 to 16.18% in 2010, decreased to 10.73% in 2014, and then increased to 27.47% in 2019. For severe ROP, the detection rate gradually increased from 0 in 2008 to 12.49% in 2019. Among the infants with ROP, 96 (7.58%) did not meet the screening criteria set by the Chinese Medical Association in 2014 (GA<32wk, or BW<2000 g); among them, 14 (1.11%) needed treatment because of severe ROP. CONCLUSION: From 2008 to 2019, the detection rates of ROP and severe ROP in infants screened in Northwest China were 16.16% and 5.63%, respectively. The characteristics of the ROP infants were similar to those in other middle-income regions. The “tertiary prevention network of ROP” is a potentially effective screening approach.