Persistent hypoglycemia in pediatric patients is usually secondary to congenital hormonal or metabolic disorders. We describe an infant with neuroblastoma and recurrent hypoglycemia. Western immunoblotting revealed high molecular weight IGF2 and Big IGF2 bands that progressively decreased in correlation with clinical improvement and normalization of blood glucose levels. IGF2-omas are a potential cause of hypoglycemia in infants with solid tumors without clear evidence of other common causes.