Objective To observe the microvessel density（MVD）and expression of vascular endothelial growth factor (VEGF) in retinoblastoma（RB）before and after comprehensive treatment and explore its clinical correlations with tumor infiltration and recurrence. Methods Sixty-one paraffin specimens of RB were divided into enucleation without comprehensive treatment group (untreated group，52 cases), planned enucleation before comprehensive treatment group (planned enucleation group，six cases) and tumor recurrence after comprehensive treatment group（recurrence group，three cases）. There were optic nerve invasion in 19 cases，no optic nerve infiltration in 33 cases. The MVD and VEGF expressions of 61 paraffin specimens were detected by streptavidin biotin-peroxidase (SP) immunohistochemistry with monoclonal antibody of CD34 and VEGF. Real time PCR was performed for the VEGF expression of planned enucleation group and recurrence group.Results In the untreated group，the MVD and VEGF expression of optic nerve infiltration cases were significantly higher than those of cases without optic nerve infiltration（t=-2.4685, P=0.017; chi;2=8.416 6，P=0.032 8）.Tumor microvessel regression, decreased MVD, occlusion and hyaline changes of blood vessels were observed in the planned enucleation group in the course of systemic chemotherapy. Many neovascularized capillaries and increased MVD were observed in tumor tissues of the recurrence group. The VEGF expression of planned enucleation group was lower than that in the recurrence group.Conclusions There was no significant difference on VEGF expression in RB between with and without comprehensive treatment. The increasing MVD and VEGF expression of cases without comprehensive treatment were related to the optic nerve infiltration. And the increasing MVD may also play an important role in RB recurrence after comprehensive treatment.