Objective: This study aimed to show the effect of zinc supplementation on growth and development in preterm neonates in the first 4 months of life. Background: Preterm infants have impaired zinc status because of low body stores as 60% of fetal zinc is acquired during the third trimester of pregnancy in addition to their limied capacity to absorp and retain micronutrients, coupled with increased endogenous losses associated with organ immaturity. Subjects and methods: The present study was carried out at Pediatric and Clinical Pathology departemets, Benha University hospital, in the period between March 2015 to Septemper 2015. on 80 healthy preterm infants between 32 and 36 weeks of age divided into two groups : zinc-supplemented group fed with breast milk, and supplemented with multivitamins and zinc (2 mg/kg/day) since the first day of life, and a non-zinc-supplemented group fed breast milk with multivitamins only (without zinc supplementation). Both groups were followed for 4 months for growth with assessment of development by the Age and Stage Questionnaire at 4 months of corrected age and serum levels of zinc at 2 and 4 months and hemoglobin at 4 months were measured. Results: In our study , it was found that the zinc-supplemented group had a significantly higher increase in weight and length at 2 and 4 months of chronological age (p < 0.001) , and non significant increase in head circumference at 2 and 4 months of chronological age (p > 0.05) compared with the non-zinc-supplemented group. Also our study found that the zinc supplemented group had significantly higher weight, length centiles (p < 0.001) and significant increase in head circumference centile (p < 0.05) than that of the non-zincsupplemented group. There was a highly significant increase in the serum zinc levels of the zinc-supplemented group at 2 and 4 months (p <0.001) compared with the non-zinc-supplemented group, in addition the zinc supplemented group had significantly higher level of HB at 4 months (p< 0.001) than that of non zinc supplemented group. Also, the developmental score of the zinc-supplemented group was