The authors present their data from Egypt assessing the effects of Ranibizumab reinjection for neonates with retinopathy of prematurity (ROP). Doses given were 0.25mg/0.025mL. They screened 2318 infants with 115 (5%) of infants with a mean post menstrual age (PMA) 38 weeks and mean birth weight 1290g requiring injection. All treated eyes showed signs of regression. Reactivation occurred in five (2.3%) eyes at an average of 9.6 weeks. Following the second injection all five eyes showed regression and complete vascularisation at PMA 60 weeks. This is an Egyptian study and the main differences with the UK is that there are no agreed screening protocols therefore practically all babies born before 37 weeks are screened. They highlight other studies which have investigated ROP reactivation following VEGF injection and provide a useful comparison. Smaller, younger neonates usually had worse disease with higher rates of intervention. Reactivation usually occurred at around 10 weeks which may be useful in risk assessing neonates post anti-VEGF. Reactivation usually manifested as stage 2 or 3 with plus disease either at the original site of the ridge or advancing edge of neovascularisation. This article highlights useful aspects of reactivation in ROP.