Aim: to determine the level of serum leptin, adiponectin and leptin /adiponectin ratio in women with hyperemesis gravidraum and compare  them  with those with normal pregnancy in order to speculate  their role in prediction and assessement of severity of the disease. Patients and method : This case control study was conducted at the department of Obstetrics and Gynecology, Ain-shams university maternity hospital. A total of 90 women are  included in the study and are divided into two groups.Group A: Fourty -five pregnant women with  hyperemesis gravidarum.. Group B  : Fourty -five pregnant women with no hyperemesis gravidarum..the groups were compared for  age, gestational age, body mass index,Leptin ,adiponectin, adjusted leptin level,,leptin to adiponectin ratio were calculated in each group. Primary outcome was the increase in adjusted leptin level in hyperemesis gravidarum group. Results: leptin was found to be significantly high in the HG group (37.91± 6.42 ) , also Adjusted  leptin  level were found to be significantly higher in the  hyperemesis gravidarum group(4.36± 1.26)  than in the control group (P = 0.001 ) and adiponectin  level were found to be  lower in the  HG (9.34±1.49) than in the control  group. There was increase in leptin to adiponectin ratio as compared with severity of the disease. The maternal  leptin level was positively correlated with gestational age in the HG group ( r = 0.011, p= 0.944 ). Also the maternal  adiponectin  level was positively correlated  with BMI  in the HG group ( r = 0.290 , p =  0.054).  Etiology of the hyperemesis gravidarum is multifactorial. However we can postulate the adjusted leptin level as a good predictor for hyperemesis gravidarum.,alsoLeptin to adiponectin ratio can be used to determine severity of the disease.