To evaluate whether healthy prepubertal children with low birthweight (LBW) exhibited higher serum levels of lipoprotein(a) (Lp(a)) than did those with normal birthweight (NBW).A total of 350 healthy children aged 6 to 9 years and in Tanner stage 1 were enrolled in a community-based cross-sectional study. Family history of hypertension, diabetes or cardiovascular disease (CVD) in parents and grandparents; active smoking; a diagnosis of acute or chronic illness; and intake of vitamins or nutritional supplements were exclusion criteria. The cut-off point for Lp(a) was 0.79 μmol/L.LBW was identified in 51 (14.6%) children. In total, 42 (12.0%) children had elevated Lp(a) levels, with 25 (49.0%) and 17 (5.7%) in the LBW and NBW groups, respectively (P < 0.0005). None of the children had adverse cardiovascular outcomes. Average body mass index (BMI) (17.1 ± 3.3 and 18.8 ± 3.9, P = 0.001), glucose levels (4.5 ± 0.5 and 4.8 ± 0.4 mmol/L, P = 0.007), insulin levels (67.4 ± 45.1 and 86.1 ± 54.9 pmol/L, P = 0.02), and Lp(a) levels (0.52 ± 0.21 and 1.40 ± 0.49 μmol/L, P < 0.0005) were higher in the children with LBW than in the children with NBW. A multivariate analysis adjusted by age, sex, raw BMI, BMI standard deviation score and insulin level showed a significant association between LBW and elevated levels of Lp(a) (odds ratio 8.02, 95% confidence interval 7.3-21.3; P < 0.0005).LBW was shown to be strongly associated with elevated serum levels of Lp(a).© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).