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To assess the association of in vitro fertilization (IVF) with neonatal outcomes and duration of stay in neonatal intensive care unit (NICU) among very low birth weight (VLBW) preterm infants.This was a cohort study of VLBW preterm infants admitted to NICU over 15 years. We assessed neonatal outcomes including composite outcome of mortality or severe morbidity, risk for major birth defects, survival without severe morbidity, and the duration of NICU stay across three birth-year epochs.A total of 1,533 infants were eligible for data analysis. Of these, 236 were born following IVF and 1,297 were born following spontaneous conception (SC). After adjustment for baseline variables, regression analysis revealed no statistically significant differences between IVF and SC groups in terms of the composite outcome of mortality or severe morbidity, risk for major birth defects, survival without severe morbidity, or duration of NICU stay.Among VLBW preterm infants, IVF had no detectable relationship with neonatal outcomes and duration of NICU stay. These findings can help provide guidance in professional counseling of affected families.