We examined whether hypotension of ≤ 1week was associated with hospital morbidities (NEC, IVH ＞ grade II, BPD, PVL, ROP) as well as mortality in very low birth weight infants (VLBWI). Further, we studied whether hypotension was associated with poor neurodevelopmental outcomes at corrected 18 months. A total of 191 VLBW infants were studied during this period. The hospital outcomes as well as neurodevelopmental outcomes at corrected 18 months were evaluated. Among the 191 VLBWI with PDA, 115 (60.2 %) patients experienced hypotension at ≤ 1 week and were associated with increased incidence of morbidities and mortality. At corrected age of 18 months, hypotension of ≤ 1week group had significantly lower scores in all three (cognitive, language and motor) composites of Bayley Scales of Infant and Toddler Development III. The multivariable logistic regression analysis showed that longer mechanical ventilation and PVL were additionally associated with worse neurodevelopmental outcomes in addition to hypotension. Conclusions: Hypotension within one week of life was associated with increased morbidities and mortality. It was also associated with increase the risk for poor neurodevelopmental outcomes.