Background: Low- birthweight (LBW) is the single most powerful predictor of mortality in the first few months of life, especially in most developing countries. The physiologic hypercholesterolemia of later pregnancy suggests an adaptive function for pregnancy maintenance or fetal growth. Decreased levels of maternal total cholesterol have been reported in association with intrauterine growth restriction. Aim: The aim of this study is to assess the association between low maternal serum cholesterol during early pregnancy and LBW in term neonates. Patients and Methods: This was a prospective cohort study in which eligible participants were enrolled at the gestational age of 14–20 weeks over a period of 12 months. Blood samples were taken to measure the total serum cholesterol concentrations, and the sera were then analyzed enzymatically by the cholesterol oxidase: p-aminophenazone method. Association between low maternal serum cholesterol and LBW was tested by using Chi-square. All significances are reported at P