Background: Low birth weight is a significant medical problem especially in regions with high prevalence. Growth hormone may have a pathophysiological role in development of low birth weight. Aim of the study: to investigate the relationship of growth hormone level at birth and birth weight to detect effect of growth hormone on intrauterine growth Subjects and methods:  This study was conducted on 66 neonates with Low birth weight. They were all full term, 35 of them were males and 31 of them were females. Meanwhile, 16 healthy neonates, 5 were males and 11 were females, served as control group.   All neonates were subjected to full maternal history taking, thorough neonatal clinical examination and determination of serum growth hormone (GH) of neonates using ELISA technique, and blood glucose level. Results of this study showed that there was a statistically significant increase in serum level of growth hormone (GH) in low birth weight neonates when compared to control neonates (P<0.001). Correlation studies revealed that among the studied neonates, there was significant negative correlation between growth hormone level and birth weight, birth length, gestational age, head circumference and abdominal circumference; there was significant positive correlation between growth hormone level and ponderal index and positive correlation between growth hormone level and blood glucose level. Conclusion: serum levels of growth hormone are increased in low birth weight neonates reflecting its protecting effect to the fetal brain from hypoglycemia through inducing insulin resistance and providing alternative fuels for metabolism through their lipolytic effects, thus suggesting increased lipolysis in low birth weight neonates