We aimed to study lipid levels in pregnant women and their neonates according to the presence or absence of environmental tobacco exposure (ETS). The study was performed in 150 pair of mothers and neonates subjects who were divided into 2 groups: those who were exposed to ETS and those who were not. 300 blood samples were analyzed for total cholesterol, triglycerides, apolipoproteins A (Apo A) and B (Apo B), and C-reactive protein (CRP). Statistically significant differences were found in TG (60 ± 229 vs. 46 ± 204 mg/dl) and Apo A (30 ± 213 vs. 33 ± 192 mg/dl) levels between the mothers in the case group and the control group (p=0.036 and p=0.02, respectively). Apgar scores in neonates of mothers exposed to ETS were significantly lower (8 ± 1) than those for neonates of mother not exposed (9 ± 0.5) (p=0.038). Expose of pregnant women to ETS causes significant increases of their serum triglyceride and Apo A, while also increasing serum CRP and decreasing Apgar scores in their neonates.