Ground sections of deciduous teeth from 64 infants with birth weights below 2000 g and from 43 healthy full-term infants were examined in polarized light and by microradiography. The deciduous enamel displayed various changes, which were more frequent and pronounced in the low-birth-weight group. The main findings were diffuse areas of increased porosity and distinct subsurface lesions in the postnatal enamel. Five teeth with enamel hypoplasia from the low-birth-weight group were also examined. The hypoplasias were all located along the neonatal line. The postnatal enamel seemed to be more susceptible to disturbances in the mineralization than the prenatal enamel. The subsurface lesions showed an arrest in the very late stages of enamel maturation, which frequently occurred in the cervical deciduous enamel. Enamel hypoplasia is considered to be a result of severe neonatal hypocalcemia.