Background: Gestational diabetes mellitus (GDM) is considered a common complication in pregnancy, affecting greater than 10% pregnancies worldwide. However, the definitive underlying causes still not fully explained. Objectives: This study aimed to detect the predictive value of uric acid level at first trimester in development of GDM. Patients and Methods: The study was conducted on 300 first trimester pregnant females attending the Outpatient Clinic of Al-Azhar University Hospital. All cases underwent measurement of first trimester serum uric acid level. Between 24 and 28 weeks of gestation glucose challenge test was done. Positive cases underwent confirmation by 3 h glucose tolerance test. Results: The Pearson's test showed that there was a highly significant correlation between serum uric acid at first trimester and plasma glucose levels at 24-28 weeks. Conclusion: There is increased risk in development of GDM with the increase in uric acid level at the first trimester.