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Vitamin A is involved in regulation of fetal lung growth. It protects the preterm lung from oxidative damage. It maintains the integrity of respiratory tract epithelium and helps in differentiation of epithelial cells. In addition, it is necessary for the formation of photosensitive visual pigment in the retina. Preterm neonates, especially very low birth weight (VLBW) have lower concentrations of plasma retinol binding protein (RBP) and plasma vitamin A concentrations than term infants. The plasma vitamin A concentrations in preterm infants with bronchopulmonary dysplasia (BPD) are still lower. Inadequate provision and delivery of vitamin A during postnatal period exacerbates this deficiency and makes these infants prone to multisystem diseases. We review here the current evidence regarding vitamin A supplementation in VLBW and extremely low birth weight (ELBW) infants, and hypothesize important research priorities in this regard.