Pyrethroid insecticides are commonly used for residential and commercial pest control in the US. Pregnant women and their fetuses are vulnerable to pesticide exposures during critical windows of neurodevelopment. Biomonitoring for exposure requires accurate and sensitive methods to assess exposures during pregnancy. The objective of this study was to develop a sensitive analytical method to measure pyrethroid metabolite concentrations in cord serum. Six pyrethroid metabolites, cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropanecarboxylic acid (c/t-DCCA), trans-chrysanthemum dicarboxylic acid (t-CDCA), cis-3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid (c-DBCA), 4-fluoro-3-phenoxybenzoic acid (FPBA), and 3-phenoxybenzoic acid (3PBA) were extracted from cord serum by a dichloromethane liquid-liquid extraction, derivatized by 1,1,1,3,3,3-hexafluoro-2-propanol carboxylic acid esterification, and then measured by gas chromatography/ion trap mass spectrometry. Limits of detection ranged from 0.02 to 0.6 ng/mL. Sixty-three cord serum samples were collected from maternal-fetal dyads in central New Jersey to test for pyrethroid metabolites. Non-specific metabolites, 3PBA, t-DCCA, and t-CDCA, were detected most frequently, present in 29%, 6.3% and 6.3% of samples, respectively. Sensitivities were comparable or greater than other published studies assessing pyrethroid metabolites in cord blood. Comparisons with other literature-reported studies emphasize the importance of method sensitivity when assessing exposures at biologically relevant concentrations.