Background: Inadequate nutrition in very low birth weight(VLBW) infants is known to be associated with growth failure and poor neurological outcomes. We aimed to investigate the association of early aggressive protein and energy intakes with weight gains and 18 month neurodevelopmental outcomes in VLBW infants. Methods: A total of 103 infants(72.5%) among 142 infants who survived to discharge were included and divided into two groups(early aggressive nutrition[n=60] vs. conventional nutrition[n=43]). Clinical findings were compared between two groups and daily protein and energy intakes were collected for the first 4 weeks of life. Multiple regression analyses tested the association between weekly protein or energy intakes and the result of each category of Denver developmental screening test II(DDST) at 18 months’ corrected age or weight gains. Results: Early aggressive nutrition group had the higher rates of normal language development at the DDST and the lower rates of growth failure( 10th percentile) at both 40 weeks’ and 18 months’ corrected age than the conventional nutrition group. After controlling for the confounding variables, higher first week protein and energy intakes each independently contributed to normal language development(odds ratio[95% confidence interval]; 5.8[1.6–27.9] per 1g/kg of protein increase and 7.0[1.7–35.6] per 10kcal/kg of energy increase). Higher first week protein intake was associated with higher weight at 40 weeks’ corrected age(r=0.38, P =0.009). Conclusions: The present study especially shows the importance of the first week protein and energy intakes in VLBW infants not only for growth but also for better language development.