BackgroundLow birth weight (LBW), defined as a live birth weighing less than 2500 g, is a significant public health problem in India. The complex nature of this problem is not fully understood. Moreover, significant disparities in LBW prevalence not only documented across various socio economic groups but across states and districts as well. The identification of spatial patterns of LBW and its determinants is important for understanding epidemiology of this public health challenge. ObjectiveThis paper examines the determinants and spatial patterns of Low birth weight prevalence spatial pattern of LBW and its determinants in India. MethodsUsing fourth round of National Family Health Survey data, regression and spatial analysis have been performed through STATA, ArcGIS and GeoDa software. ResultsThe result indicates lower odds of LBW prevalence among educated mothers, mothers who have more than 4 ANC visit, mothers who took IFA tablets during pregnancy, mothers with normal BMI and mothers with age above 20 years. The Moran's I for LBW is 0.543. It indicates high spatial autocorrelation in LBW over the districts of India The bivariate LISA maps obtained indicate spatial distribution of LBW and independent variables systematically contrasts the districts of central and eastern India (e.g. in Uttar Pradesh) with those of the extreme south (e.g. in Tamil Nadu, Kerala, etc.). ConclusionOur findings reveal greater attention towards maternal and child health care especially for the backward districts in the states of Uttar Pradesh (UP), Madhya Pradesh (MP), Bihar and Rajasthan are needed. Several maternal and social factors leads to the occurrence of low birth weight. Emphasis should be placed on improving the nutritional status of the mothers.