This study estimated the risk of very-low-birthweight delivery among Black and White women with selected treatable antepartum medical conditions. A logistic regression model was applied to a retrospective, population-based data set identified by computerized, linked birth certificate and maternal hospital discharge records. For Black mothers, the adjusted odds ratio for very-low-birthweight delivery was statistically significant for essential hypertension and urinary tract infection. For White mothers, the adjusted odds ratio was statistically significant for essential hypertension, urinary tract infection, pregnancy-induced hypertension, and diabetes mellitus. Public policy designed to reduce the risk of very-low-birthweight delivery must include strategies for attenuating the impact of treatable antepartum medical conditions.