AIM To report our initial experience with lens-sparing vitrectomy for stage 4 retinopathy of prematurity using the 27-gauge(G)system.METHODS This retrospective case series involved nine eyes of five babies with active stage 4 ROP,who underwent 27-G lens-sparing vitrectomy.Surgery was done using 27-G valved cannulas and sclerotomies were made 1.5 mm from the limbus.Bilateral sequential vitrectomy was done in eight eyes.RESULTS At one-year follow-up,anatomical outcome was favourable in all nine(100%)eyes.High-speed cutting and smaller sclerotomies were helpful in reducing the intra and post-operative complications.CONCLUSION 27-G vitrectomy is well suited for stage 4 ROP surgeries.