Objective To compare the effect of caffeine citrate and aminophylline on neurological development in preterm infants, in order to provide reference for the early intervention of preterm infants. Methods Totally 62 infants with apnea of prematurity (AOP) treated with caffeine citrate was enrolled as study group from June 2014 to June 2018,and 69 AOP infants treated with aminophylline were selected as control group from December 2011 to May 2014.Brain magnetic resonance image(MRI)scanning was conducted to compare white matter disease(WMD) between caffeine citrate group and aminophylline group at 3 to 8 days after birth and corrected gestational age of 40 weeks.Neurological development was assessed by Gessell Scales of Infant Development in 6 months and 12 months and was compared between the two groups. Results There were no significant differences on sex, gestational age at birth, birth weight, glucocorticoids use before birth and delivery mode, Apgar score at 5 minutes, assisted ventilation, as well as surfactant therapy between caffeine citrate and aminophylline group(P>0.05).Difference on WMD between the two groups was not found at 3 to 8 days after birth(P>0.05), but it was significant at corrected gestational age of 40 weeks(P<0.05).After following up to corrected age of 6 months, the scores of gross motor, fine motor, personal-social contact in caffeine citrate group were significantly higher than those in aminophylline group(P<0.05).And after following up to corrected age of 12 months, the scores of gross motor, fine motor, language and adaptability in caffeine citrate group were significantly higher than those in aminophylline group(P<0.05). Conclusion Caffeine citrate can potentially improve the neurological development outcome of AOP infants at 6 and 12 month old.