Objective: This study aims to compare growth parameters and neurodevelopment outcomes between preterm infants conceived via assisted reproductive technology (ART) and those conceived spontaneously, with a focus on head circumference, length, weight, and developmental performance as assessed by the Gesell Developmental Scales. Methods: Propensity score matching was employed to balance baseline characteristics between groups. Post-matching comparisons were conducted for head circumference, length, and weight at birth, 1 month, and 3 months of age. Neurodevelopmental assessments were performed at 1, 2, and 3 years using the Gesell scales. After PSM, a total of 290 preterm infants were included in the final analysis, with 145 infants in each of the ART and non-ART groups, respectively. Results: Following matching, baseline characteristics were comparable between the groups. At both 1 month and 3 months of age, ART-conceived infants group demonstrated significantly lower mean head circumference, length, and weight compared to infants conceived spontaneously. Additionally, ART-conceived infants demonstrated significantly lower developmental scores at 1 and 2 years of age (p < 0.05). Conclusions: Preterm infants conceived via ART exhibited comparatively lower growth metrics developmental scores during early infancy compared to their spontaneously conceived counterparts. These findings highlight the importance for proactive clinical monitoring and targeted early interventions to support optimal outcomes in this population.