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Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness worldwide. In Guatemala, a large number of premature infants are born in hospitals outside the capital city and present for evaluation at advanced stages of the disease.Objectives To compare the cost of timely screening and treatment versus the total cost of comprehensive management for patients with visual disability secondary to ROP.Patients and Methods The cost of the disease was calculated in patients presenting with low vision or blindness secondary to ROP. Direct costs were calculated based on those directly related to disease management: medical care, rehabilitation, education, technical support, transportation, personal assistance, home adaptations, and specialized equipment. These were compared with the costs of timely screening and treatment.Results The total cost of managing a child with severe visual disability due to ROP was USD 214,666.37, whereas the cost of timely screening and treatment was USD 1,223.12. This represents an additional cost of USD 213,443.24 for patients who were not screened and treated in time.Conclusions The cost of timely screening and treatment represents only 0.57% of the total lifetime cost of managing a child with severe visual disability due to ROP.