Reports from the Aga Khan University indicate that 58% of 400 school children studied had undesirably high serum cholesterol levels. The present study was undertaken to determine whether the high cholesterol levels are present at birth and to determine the relationship between cord blood, maternal blood cholesterol and maternal diet. Cord blood from 58 neonates and fasting venous blood from 45 mothers were analyzed from total serum cholesterol. Mothers were interviewed regarding their usual diet during pregnancy. Mean cord blood cholesterol was 56.90 mg/dl (range 26 to 123 mg/dl). Mean maternal blood cholesterol was 232.4 mg/dl (range 141-382 mg/dl). Mean maternal intake of cholesterol was 457 mg (recommended level less than or equal to 300 mg/day). There was no significant co-relation between cord blood cholesterol and maternal blood cholesterol or maternal intake of cholesterol. Eighteen percent of the mothers reported a strong family history of hypercholesterolemia and/or heart disease, but this genetic tendency was not observed in the blood cholesterol level at birth indicating that environmental factors namely diet may have a prime role in determining serum cholesterol levels in childhood.