Objective: Abnormal fat metabolism is a major disorder in adults who were small for gestational age (SGA). Peroxisome proliferator-activated receptor (PPARc) participates in adipocyte differentiation and the regulation of lipid metabolism. This study explored the role of PPARc in the regulation of fat catch-up growth (CUG) and the lipid metabolism of SGA individuals. Methods: The CUG-SGA rats were treated with pioglitazone. The weight of the visceral adipose tissue, serum lipid levels, and PPARc expression in the visceral adipose tissue were detected at 4, 8, and 12 weeks of age. Results: The PPARc expression in the visceral adipose tissue in the CUG-SGA group was lower than that in the appropriate for gestational age (AGA) group at 4, 8, and 12 weeks (P < 0.05). The serum triglycerides in the CUG-SGA group were elevated compared with that in the AGA group at 4 and 12 weeks (P 5 0.005; P 5 0.037); however, they were significantly decreased after 8 weeks of pioglitazone intervention (P 5 0.001). Conclusions: PPARc expression in the visceral adipose tissue was lower in SGA rats and may be related to the regulation of adipocyte differentiation. The early increased PPARc expression by pioglitazone might reduce serum triglycerides and decrease the CUG of the visceral adipose tissue in SGA.