This report describes the goal, activities, and outcomes of the Queen Elizabeth Diamond Jubilee Trust funded retinopathy of prematurity (ROP) program in the state of Maharashtra in collaboration with the Public Health Foundation of India, Hyderabad. The project was initiated in July 2016 with the goal of establishing a sustainable ROP program in the special newborn care units (SNCUs) in public health facilities of five districts. Between 2016 and 2018, ophthalmology and neonatology teams from five district hospitals (DHs) were trained by nongovernment partner hospitals in the state. Infrastructure was developed by procuring equipment for ROP screening/treatment, and awareness generation activities were conducted with a range of stakeholders. Eight ophthalmologists were trained to perform ROP screening (from five DHs and one medical college), and five neonatology teams (pediatricians and nurses) from the project hospitals were trained in best neonatal practices to prevent ROP. The Pune district's hospital was developed as an ROP treatment center. Toward the end of the project period, six new facilities had an established ROP program. The state health department is in the process of scaling up the ROP program to a larger geographic region to ensure universal ROP screening coverage in the state of Maharashtra.