The aim of the present study was to elucidate the structural and chemical peculiarities of dental enamel in prematurely born children. A case-control clinical study was conducted on a sample of 978 children aged 1 to 15 years, divided into two proportional groups based on enamel structure. The research group L1 consisted of 326 prematurely born children (according to anamnesis data), and the control group L0 included 652 conventionally healthy children. The prevalence indices of dental caries (DC) were assessed. The structure and chemical composition of enamel samples obtained from teeth extracted for medical reasons were analyzed. Scanning electron microscopy (SEM), radiospectral microanalysis (RSMA) using energy-dispersive X-ray spectroscopy (EDX) with a material-type detector, and Atomic Force Microscopy (AFM) were performed. SEM and AFM investigations revealed the following structural and chemical features of dental enamel in prematurely born children: an increased proportion of organic components in relative to mineral components; the presence of areas with numerous pores and disorganization of structural elements on the enamel surface; and a decreased mass percentage of P, Ca, Cl, Mg and Na. Conclusions. The structural and chemical features of dental enamel identified at both molecular and macroscopic levels in prematurely born children indicate an increased risk of developing DC. These findings support the need for the implementation of effective preventive measures.