I read the recent review article [1] on management of patent ductus arteriosis (PDA) in very low birth weight (VLBW) infants with interest. I wish to seek clarifications regarding authors’ conclusion about birth weight <800 g (without any reference to gestational age) being a deciding factor for treatment when babies with PDA are symptomatic or require positive pressure ventilator support. The reference quoted [2] reports significant effect on mortality and morbidity in the presence of persistent PDA only with gestational age <25　weeks. Moreover, there is evidence that the rate of spontaneous closure in babies weighing >1000g at birth is significantly high [3], and hence interventions for ductal closure may be relevant only in those having birth weight £1000g. Furthermore, neither individual randomized controlled trials nor meta-analyses of those trials have been able to demonstrate any long term benefits of interventions for ductal closure in babies with PDA, irrespective of the gestational age and birth weight [4,5]. In this context, should management of these infants be guided only by clinical judgement on an individual basis, irrespective of gestational age or birth weight?