Background: Gestational diabetes mellitus (GDM) is a common complication in pregnancy, affecting more than 10% pregnancies worldwide. However, the true underlying causes remain to be fully elucidated. Aim: This study aimed at searching for any relation between first trimester uric acid concentration and the development of GDM. Subjects and Methods: The study was conducted on 250 first trimester pregnant females at risk of diabetes mellitus attending the outpatient clinic of Tanta University Hospital. All cases underwent estimation of first trimester‑fasting blood sugar and maternal serum uric acid concentration. Between 24 and 28 weeks’ gestation random blood sugar and glucose challenge test were done. Positive cases were confirmed by 3 h glucose tolerance curve. Results: The results demonstrated an association between first trimester maternal serum uric acid concentration obesity and GDM. Approximately, 41.4% (60/145) of non‑diabetic women were at first quartile, while 44.8% (47/105) of the diabetic women were at fourth quartile. Conclusion: We concluded that the cut‑off level of maternal serum uric acid of 4 mg/dl in the first trimester was associated with developing GDM. Therefore, we suggest that serum uric acid level should be done as routine test during the first antenatal care visit.