Objective: Bronchopulmonary dysplasia is one of the most frequent complications of preterm infant for which long-term azithromycin, although not recommended, is sometimes prescribed for its possible bronchial anti-inflammatory effects. Materials and methods: This retrospective observational descriptive study compared the effect of long-term azithromycin on oxygen withdrawal and clinical outcome (body mass index, hospitalization for asthma or low respiratory infection, presence of inhaled therapy) at 6 months, 1 and 2 years in preterm infants with bronchopulmonary dysplasia needing oxygen therapy or respiratory support at 36 weeks. Children, born between 1/1/2017 and 31/6/2021 before 30 weeks, were paired on term, sex, and presence of antenatal corticosteroid therapy (1 patient on azithromycin for 3 not treated). Data were compared between groups by Student’s t-test, chi-square test or Fisher’s test. Results: Of 210 eligible patients, 56 were included (sex ratio: 1.8; mean gestational age: 26.4 weeks; mean birth weight: 778.2g). Azithromycin was prescribed from 85 days of life to 19.5 months in mean in 14 patients. At the age of 2 years, these patients had a trend to be more treated with oxygen (3/14, 21.4% vs 2/42, 4.7%; p=0.06). Non-invasive ventilation was more frequent (p<0.05). Body mass index was lower at 1 and 2 years, and inhaled treatments more prescribed at all ages in the azithromycin group. The rate of hospitalization for respiratory diseases was not different in the 2 groups. Conclusion: In real-life long-term azithromycin does not reduce the duration of oxygen therapy in preterm infants with bronchopulmonary dysplasia.