A retrospective study compared the efficacy of intravitreal ranibizumab (IVR) and conbercept (IVC) in 294 infants (565 eyes) with retinopathy of prematurity (ROP) at Gudangd Hospital from April to June 2024. The disease reactivation rate was 10.39% (43 of 414 eyes) in the IVR group and 12.58% (19 of 151 eyes) in the IVC, no significant difference (p = 0.46). Mean time to reactivation was 8.92 ± 2.01 weeks for IVR and 8.78 ± 1.68 weeks for IVC (p = 0.84). Multivariate analysis showed that lower postmenstrual age (PMA) at baseline (p = 0.001) and zone I ROP (p = 0.008) were significant independent risk factors for reactivation. Gestational age, birth weight, gender, or other systemic comorbidities were not significantly associated with reactivation. Both ranibizumab and conbercept are effective in the treatment of ROP, with infants with lower PMA and zone I ROP requiring closer and longer follow-up after anti-VEGF therapy.