Objective To study the differences of clinical characteristics of extremely and very low birth weight ( E/VLBW) infants conceived with assisted reproductive technology ( ART) and spontaneous conception ( SC) .Method From July 2014 to July 2016, preterm infants with birth weight less than 1500 g admitted to neonatal intensive care units of First Affiliated Hospital of Zhengzhou University were retrospectively studied.They were assigned into ART group and SC group according to their fertilization methods.Their general condition , major complications , respiratory support strategy , duration of hospital stay, hospitalization cost and mortality rate between the two groups were compared using t test, U test andχ2 test.Result A total of 527 preterm infants were included , with an average gestational age of ( 30.6 ± 2.0) weeks (25.4 to 36.0 weeks) and an average birth weight of (1198 ±202) g (500 to 1490 g). 88 infants were ELBW infants and 439 VLBW infants.156 infants were small for gestational age ( SGA ) infants and 371 appropriate for gestational age infants .According to their fertilization method , 81 infants were assigned into ART group and 446 infants SC group.The gestational age of ART group was lower than SC group, and the incidence of double/multiple birth was higher than SC group , the differences were statistically significant (P<0.05).Compared with SC group, the hospitalization duration and cost of ART group were significantly higher ( P <0.001 ) .The incidences of respiratory failure , bronchopulmonary dysplasia, sepsis, fungal infection, heart failure, disseminated intravascular coagulation and multiple organ dysfunction syndrome in ART group were higher than SC group ( 48.1% vs.34.8%, 50.6% vs.16.1%19.8%vs.7.0%, 8.6%vs.2.9%, 39.5%vs.17.7%, 22.2%vs.7.2%, 29.0%vs.15.0%) , and the incidence of hyperbilirubinemia was lower than SC group (81.5%vs.90.8%).The differences were all statistically significant (P<0.05).No significant difference existed in respiratory support strategy between the two groups ( P>0.05 ) .Conclusion Compared with spontaneous conception , ART method does not increase the risk of death among E/VLBW infants.However, ART conceived infants have potential risks of lower gestational age , higher double/multiple birth rates , higher complications incidences , longer hospitalization duration and higher hospitalization costs .Perinatal care and management are important for these infants.