Systemic hypotension is a relatively common complication of extremely low gestational age newborns, which may increase mortality and neuro-developmental morbidity. Because of the lack of agreed standards on the diagnosis, management and outcomes of hypotension in the extremely low gestational age newborns, treatment of hypotension among neonatal intensive care units varies widely. Unified clinical guidelines for hypotension in extremely low gestational age newborns should be made through multi-center and large sample perspective study.