The objective of the study discussed in this article was to evaluate the impact of residential proximity to toxic release sites (TRS) and potential implications for low birth weight (LBW) and premature delivery in Shelby County, Tennessee women. The sample (N = 369) included pregnant women who participated in the Blues Project (2007-2009). ArcGIS was used to map the mother's residence at delivery and distance from each of the 10 TRS. Multivariate logistic regression was used to predict LBW and prematurity based on proximity to TRS, while adjusting for probable confounders and effect modifiers. Proximity to Site 8 (odds ratio [OR] = 4.018, confidence interval [CI] = 1.103-14.643) and Site 10 (OR = 2.667, CI = 1.036-6.862) put mothers at increased risk for preterm births. The authors' findings suggest that residential proximity to Site 8 or Site 10 may be a risk factor for premature delivery in Shelby County women.