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Background and objective: Nowadays, air pollution is a very serious problem that affects everyone especially old people, pregnant women and their fetuses, infants and all high-risk patients. This study was done to survey the effects of carbon monoxide of air pollution on fetus and changes in umbilical cord pathology. Methods: In this historical cohort study, the effect of carbon monoxide of air pollution on fetus and umbilical cord was studied in Mahdieh hospital in Tehran (Case group) and Fayazbakhsh hospital in Karaj (Control group) in 2001-02. We compared case group born to mothers who were exposed to outdoor air pollution during pregnancy (N=32), and the control group born to the mothers who were not routinely exposed to air pollution (N=32). Two groups were similar in maternal age, gestational age, gravida and family income. Carbon monoxide, carboxyhemoglonin, birth weight and umbilical disorders were compared in two groups and the relationship between carbon monoxide with these variables was evaluated. Findings: Carbon monoxide levels were 16.69 ppm in case group and 2.68 ppm in control group (P