Maternal cigarettes smoking have many negative effects on both the mother and fetus during pregnancy. Discontinuation of smoking can have many long-term benefits for both. There are special programs available to pregnant women and those thinking about conceiving to help quit smoking. Our study was done to high light the association between tobacco smoke exposure of pregnant mothers and blood pressure of their newborns.Our study is a prospective cohort review included 200 neonates. The neonates were divided into two groups: The first group represented the non smokers and they were 100 neonates, whereas the second group represented the smokers and they were 100 neonates. The later group was further subdivided into two subgroups, passive smokers and active smokers. The active smokers were categorized according to the number of cigarettes smoke into three groups. We found a statistically significant difference (P value 0.001) in neonatal systolic and diastolic blood pressure between smoking group and non smoking group. We also revealed significant correlation between the number of cigarettes smoke and neonatal blood pressure i.e. the greater the number of cigarettes smoke the higher the systolic and diastolic blood pressure of neonates. We also revealed the effect of smoking on neonatal anthropometric measurements. Birth weight of neonates of smoking group was statistically significantly lighter (P value 0.001). than those of non smoker mothers. Neonatal head circumference of smoking group were slightly reduced than those of non smoking group, although not statistically significant. (P value 0.029). Neonatal length of smoking group was statistically significantly shorter at birth than those of non smoking group (P value 0.001).Conclusion: We concluded that Smoking during pregnancy has substantial effect on neonatal systolic and diastolic blood pressure. We also revealed that smoking during pregnancy affected neonatal anthropometric measurements. (Birth weight, length, and head circumference).