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To determine the occurrence of hypoglycemic episodes in very low birth weight preterm infants under total enteral nutrition and identify potential risk factors.In this single centre cohort study, we analyzed the patients' charts of preterm infants with a gestational age32 weeks (n = 98). Infants were analyzed in two groups (group 1: birth weight1000 g, n = 54; group 2: birth weight 1000-1499 g, n = 44). A total of 3640 pre-feeding blood glucose measurements were screened. Risk factors for the development of hypoglycemia were identified by linear and multiple logistic regression analyses.In group 1, 44% (24 of 54) of infants experienced at least one asymptomatic episode of blood glucose45 mg/dl (2.5 mmol/l) as compared with 23% (10 of 44) in group 2. Regression analysis identified low gestational age and high carbohydrate intake as potential risk factors for the development of hypoglycemia.Our results indicate that numerous preterm infants experience hypoglycemic episodes once on total enteral nutrition, especially those who are1000 g at birth and those with a higher carbohydrate intake. Further studies evaluating a possible impact of these common although asymptomatic episodes on later development could help to better define thresholds that should be considered as "hypoglycemia" in this population.