Molar incisor hypomineralization (MIH) is a qualitative developmental enamel defect that affects one to four permanent first molars, with or without involvement of permanent incisors. Its etiology is of systemic origin, but is not well understood. Therefore, we conducted this cross-sectional study to examine pre-, peri-, and postnatal risk factors for MIH among children, 7–8 yr of age, in urban areas of Khon Kaen, Thailand. Molar incisor hypomineralization defects were diagnosed using the European Academy of Pediatric Dentistry criteria. Mothers or primary caregivers were interviewed on maternal medical history and habits during pregnancy, pregnancy and delivery complications, and the child's medical history. Molar incisor hypomineralization defects were observed in 78 (27.7%) of 282 children. Multiple logistic regression analysis showed a statistically significant association between the development of MIH and Cesarean section (adjusted OR = 2.0, 95% CI = 1.1–3.7), complications during vaginal delivery (adjusted OR = 4.5, 95% CI = 1.9–11.0), and severe/chronic illness when under 3 yr of age (adjusted OR = 2.9, 95% CI = 1.6–5.0). There was no association of preterm birth and low birth weight with MIH. The results suggest that Cesarean section, complications during vaginal delivery, and poor health during the first 3 yr of life are independent risk factors for MIH.