This study was done to analyse effect of early (80 mL/kg/day) versus late fortification (150 mL/kg/day) in preterm neonates on anthropometry at discharge, anthropometry and neurodevelopment at 6 months’ corrected age.Sixty-six preterm neonates (gestational age-26-24 weeks and birth weight 600-1800 grams) were randomized. Primary outcome was rate of weight gain (g/kg/day) after regaining birth weight during NICU stay; which was analysed by three different methods as secondary outcome. Various morbidities, side effects of fortification, anthropometry, neurodevelopment by Trivandrum Development Screening Chart (TDSC) at 1, 3, and 6 months’ corrected age were also studied. In results, baseline neonatal and maternal characteristics were comparable. Median birth weight [1430 g (IQR:1192–1675) vs 1436 g (IQR:1242–1622); p=0.980] and gestational age [31 weeks (IQR:30–33) vs 32 weeks (IQR:30–33); p=0.571] were similar. Early fortification showed higher median weight gain velocity (18.3 vs 14 g/kg/day; p=0.062) though not statistically significant. Subgroup analysis and analysis of rate of weight gain by three different methods showed uniform trend favouring early fortification. Linear and head growth were similar. Rates of necrotising enterocolitis, feed intolerance, extra-uterine growth restriction, mortality, post-discharge growth and neurodevelopment were also similar. It was concluded that early fortification of feeds at around 80 mL/kg/day appears feasible and safe in preterm neonates, with consistent trends toward improved growth velocity but post-discharge growth and short-term neurodevelopmental outcomes are similar.