To compare thyroid hormone levels between septicemic preterm neonates with and without shock. Preterm septicemic infants with shock constituted Group A (n=36) and those without shock constituted Group B, with groups matched (1:1) for gestation and postnatal age. Those with maternal thyroid disorders, thyrotropic medication and life expectancy < 12 hours were excluded. We compared serum tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) between the groups by univariate and multivariate (adjusting for SNAPPE-II) analysis. Median (IQR) TSH was significantly lower in Group A [1.39 (0.83,3.48)] vs Group B [5.1 (2.32,7.19)] mmol/dL (P < 0.001). Serum T3 and T4 were also lower in Group A (P < 0.001). On multivariate analysis, none of these measures were independently associated with septic shock. Thyroid hormone levels do not independently predict presence of shock among septic preterms.