To evaluate the efficacy and safety of the bedside diode laser photocoagulation for severe retinopathy of prematurity in neonatal intensive care unit (NICU). Data of 103 patients with prethreshold or threshold retinopathy of prematurity (ROP), treated with diode laser photoablation after vecuronium-induced anesthesia and mechanical ventilation from March 2009 to July 2011 in NICU of Bayi Children's Hospital. Totally 199 eyes in 103 patients received laser therapy with at least 5 months follow up. Among these eyes, zone I disease was found in 76 eyes (38.2%) of 39 infants, zone II disease was found in 123 eyes (61.8%)of 64 infants and additional disease was found in 180 eyes of 91 infants. After treatment 191 (96.0%) of 199 eyes had favorable outcomes and 8 developed to partial retinal detachment. The rate of favorable outcomes in zone I diseases and zone 2 diseases were 89.5% and 100% respectively. The laser therapy was undertaken in all patients safely and the use of ventilator was stopped quickly [after a mean of (6.7 ± 1.3) h]. Bedside laser photocoagulation in NICU is a safe and effective treatment mode for severe ROP and should be used widely.