Objective <p>To compare proteinuria in preterm neonates with fetal growth restriction-small for gestational age (FGR-SGA) against equally preterm but appropriate for gestational age (AGA) neonates.</p> Study design <p>Prospective, observational cohort study.</p> Results <p>Eighteen FGR-SGA neonates were compared with 18 AGA neonates (gestation; 29 ± 1 vs 29 ± 2 weeks, <i>P</i> = 0.8). Urine total protein (median [interquartile range]) in FGR-SGA was higher 370 [323, 573] vs 255 [193, 453] mg/L in AGA, <i>P</i> = 0.017 at first assessment (week one) and 565 [445, 743] vs 225 [135, 458] mg/L, <i>P</i> = 0.0011 at second assessment (week four). Urine protein creatinine ratio was 393 [250, 445] in FGR-SGA vs 227 [163, 367] mg/mmol in AGA, <i>P</i> = 0.029 at first assessment and 444 [368, 699] vs 240 [199, 411] mg/mmol, <i>P</i> = 0.0014 at second assessment. Mean blood pressure was higher in FGR-SGA group &amp; directly correlated with proteinuria.</p> Conclusions <p>Increased proteinuria in FGR-SGA suggests reduced nephron endowment and hyper-filtration.</p>