Objective: To evaluate the association between a common cell-cell interaction variant, intracellular adhesion molecule 1 (ICAM1) K469E, and gastroschisis risk in Indonesia. Summary of Background Data: Gastroschisis is a congenital disorder characterized by fetal intestines' extrusion outside the body. Several hypotheses have been proposed for gastroschisis, including an impairment in the normal attachment between umbilical cord and umbilical ring. Methods: A total of 48 infants with gastroschisis and 88 ethnicity-matched controls were involved in this study. The ICAM1 K469E polymorphism was analyzed using polymerase chain reaction-restriction fragment-length polymorphisms on genomic DNA. Results: The frequencies of genotypes for ICAM1 K469E in patients were KK, 30 of 48 (63%); KE, 17 of 48 (35%); and EE, 1 of 48 (2%), whereas their frequencies in controls were KK, 48 of 88 (55%); KE, 33 of 88 (37%); and EE, 7 of 88 (8%). Those frequencies were not significantly different between both groups (P ¼ 0.37) with an OR of 1.39 (95% CI, 0.68-2.85). The K469 allele had a frequency of 80% (77 of 96) in patients and 73% (129 of 176) in controls, and the frequency in patients was not significantly higher than that in controls (P ¼ 0.20), with an odds ratio of 1.48 (95% confidence interval, 0.81-2.70). In addition, the frequency of ICAM1 K469 allele in patients with maternal age younger than 25 years was