<p>A prospective study in a neonatal intensive care unit in urban India examined bone mineral density (BMD) and its association with serum markers of metabolic bone disease of prematurity (MBDP). Dual-energy X-ray absorptiometry and tests for serum ionic calcium, phosphorous, alkaline phosphatase, vitamin D, and parathyroid hormone were performed at 3–4 wk age for 121 neonates (72 male) of 26–33 wk’ gestation (median = 31). In univariable analyses, headless BMD (mean = 0.180&#xa0;g/cm²; SD = 0.039) had no association with sex, gestation period, age, duration of total parenteral nutrition, occurrence of anemia, bacterial infection, bronchopulmonary dysplasia, or intraventricular hemorrhage, or maternal gravidity, antenatal steroid or MgSO₄ use, or diabetes, hypertension, or intra-uterine growth retardation. However, BMD was associated positively with birth weight (<i>p</i> = 0.036) and negatively with pre-eclampsia (<i>p</i> = 0.020). Among serum markers, only calcium correlated with BMD (beta = -0.066; <i>p</i> = 0.029). MBDP prevalence in the cohort was determined as varying from 6% to 39% depending on diagnostic criteria.</p>