Aim: To study the effects of erythropoietin-beta in VLBW infants with anaemia of prematurity on their ferritin, reticulocyte, haemoglobin levels and transfusional requirements during the first month of treatment.Methods: Routine blood sampling for ferritin, haemoglobin and reticulocyte counts were done weekly for VLBW infants receiving 750U/kg of erythropoietin in 3 divided doses per week and daily oral iron of 6mg/kg according to our unit policy.Results: Over a 9-month period, 35 infants (17 males,18 females) received erythropoeitin. Their mean gestation was 29±2 weeks and mean birthweight was 1.08±0.24 kg. The median haemoglobin level pre-erythropoietin was 10.9g/dL; ferritin, 222mcgl/L; and reticulocyte count, 2.9%. Erythropoietin was commenced after the first three weeks of life (mean, 23+5 days; range,13 to 33 days). The earliest response observed was a 2.5- fold increase in reticulocytes (median, 7.2%; p< 0.01) after one week of therapy (3 doses). After 3 weeks of treatment (9 doses), the average ferritin level decreased by 50% (median, 104mcg/dL; p=0.011), but the haemoglobin maintained stable at 10.4g/dL vs the initial 10.8g/dL, p = 0.25. All but ten infants (29%) required blood transfusion because of concomitant illnesses or poor weight gain.Conclusion: The use of erythropoietin-beta was associated with an early rapid increase in reticulocytes and a significant fall in ferritin levels. Monitoring and ensuring iron adequacy is vital to prevent iron-deficiency during erythropoietin therapy. Nine doses of erythropoeitin-beta commenced at 3-4 weeks postnatal age maintained haemoglobin levels above the blood transfusion threshold in the majority of our VLBW infants before hospital discharge.