Objectives: Autism is a developmental disorder characterized by social and emotional deficits, language impairments and stereotyped behaviors that manifest in early postnatal life. This study aims to clarify the role of selected ions related to energy metabolism as a consequence of oxidative stress in the deterioration accompanied autism., Materials and Methods: Malonaldehyde as measure of lipid peroxidation, Na(+)/K(+) ion pump (ATPase), together with the concentrations of Na(+), K(+), Mg(2+), Ca(2+) and Pb(2+) were determined in plasma of 30 Saudi autistic patients and compared to 30 age-matching control samples., Results: The obtained data recorded that Saudi autistic patients have a remarkable higher activities of Na(+)/K(+) ATPase and high levels of lipid peroxidation compared to control. In addition, they have significantly elevated levels of K(+) and Pb(2+) while Ca(2+) recorded a significantly lower level compared to age-matching control subjects. On the other hand both Mg(2+) and Na(+) were non-significantly changed in autistic patients., Conclusion: Alteration of the selected measured ions confirms that oxidative stress and defective mitochondrial energy production could represent the primary causative factor in the pathogenesis of autism., (Copyright 2009 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)