OBJECTIVE: To study the therapeutic effects of recombinant human erythropoietin (rhu Epo) on anemia of prematurity in very low birth weight (VLBW) infants. METHODS: Fifty six VLBW premature infants were randomly assigned into two groups: the treated group (n=30) and the control group (n=26). The treated group received rhu Epo (300 IU/kg) twice weekly for 4 weeks by subcutaneous injection from the 8 th day of life, and was treated with oral supplement of vitamin E (5～10 mg/kg.d) from the 3 rd week of life. Oral supplement of vitamin E (5 mg/kg.d) and folic acid (5 mg/d) was given in the two groups from the 7 th day of life. They were followed up until 4 months of age. RESULTS: ①The Hb, RBC and Reticulocyte (Ret) counts in the treated group and the control group decreased gradually. There were significant differences in Hb, RBC and Ret between the two groups on the 7 th , 14 th , 21 st , 28 th and 35 th day (P< 0.01 or 0.05 ). ②After the treatment, the serum iron protein level in the treated group significantly differed from that of the control group [( 103 ± 25 μmol/L vs (123±24) μmol/L](P< 0.01 ). ③The prevalence of anemia in the treated group was obviously lower than that in the control group (43% vs 89%) (P< 0.01 ). CONCLUSIONS:  Early administration of high dosage rhu Epo can reduce the degree of anemia of prematurity and reduce or even replace the need of blood transfusion.