Abstract Background While the impact of light pollution on human health is gaining recognition, its role in transmitting the effects of maternal exposure to the fetus remains unclear. This study is to investigate the association between exposure to artificial light at night (ALAN) during pregnancy and risk of congenital glaucoma. Methods All birth cohorts spanning from 2008 to 2011 in urban areas of South Korea, comprising over 90% of the total population, were identified in the Korean National Health Insurance database. Average levels of ALAN at the residential addresses of mothers during pregnancy were estimated using time-varying satellite data for a composite view of persistent night-time illumination at ∼1 km2 scale.The odd ratios (ORs) and 95% confidence intervals (CIs) of the association between residential ALAN and risk of congenital glaucoma - was computed using logistic regression. These calculations were adjusted for socio-demographic factors and area-level risk factors (night-time traffic noise and particulate matter with an aerodynamic diameter ≤ 10 μm). Results A total of 745,458 mother-father-child trios (mean [SD] age of the mothers, 32.4 [3.8] years; 387,275 [52.0%] boy) were included in the study. In fully adjusted models, an IQR (21.8 nW/cm2/sr) increase in ALAN level was associated with an OR of 1.12 (95% CI: 1.05, 1.19) for incident congenital glaucoma. The exposure-response curve demonstrated an upward slope with a threshold at approximately 62 nW/cm2/sr. Conclusions In this nationwide population-based case-control study, higher levels of residential ALAN during pregnancy were associated with increased risk of congenital glaucoma. Future studies with more detailed information on exposure, individual adaptive behaviors and potential mediators are warranted. Key messages • This study indicates an association between elevated levels of ALAN exposure in pregnant women and a heightened risk of congenital glaucoma in their offspring. • These results are consistent with a growing body of evidence underscoring the detrimental effects of ALAN on health, reinforcing its potential role as a risk factor for congenital glaucoma.