Background To investigate the clinical and histopathological features of eyes enucleated due to retinoblastoma in a 50-year period in China. Methods The study included all eyes enucleated for retinoblastoma in the Beijing TongRen Hospital in the study period from 1957 to 2006. The clinical and histological charts, and histological slides were assessed for demographic and clinical data, and histological findings. Results The study included 1234 eyes. The mean age at the time of diagnosis (2.8 +/- 1.8 years) with a peak at 1 year of age decreased significantly (p<0.001) during the study period. Children with a unilateral retinoblastoma were significantly (p<0.001) older than children with bilateral retinoblastoma. The mean delay in the diagnosis (5.5 +/- 7.2 months) was significantly (p<0.0001) associated with the age at the time of diagnosis and significantly (p<0.0001) decreased during the study period. The presenting symptoms were leucocoria (67.2%), poor vision (10.8%), a detectable tumour mass (6.4%), red and painful eye (5.3%), strabismus (4.4%), exophathalmos (2.1%) and trauma (2.3%). Prevalence of an extraocular tumour extension decreased significantly (p<0.0001) during the study period. The frequency of a tumour invasion into the retro lamina cribrosa tissue or into the choroid decreased from 45.5% and 60.6% in the period 1956-1961 to 21.5% and 18.6%, respectively, in the period 2002-2006. Conclusions In the last 50 years, the diagnosis of retinoblastoma in China has been improved markedly with a shorter delay in the diagnosis, an overall earlier diagnosis and a decrease in the clinical and histological stage at the time of treatment.