Population-based twin data were used to test (a) whether lower birthweight confers a greater risk of adult health disorders, and (b) whether within-pair birthweight differences in twins explain discordance for health outcomes. The sample consisted of 1201 monozygotic (MZ) male twins, 1048 dizygotic (DZ) male twins, 1679 MZ female twins, 1489 DZ female twins, and 2423 opposite-sex DZ twins, born in Norway between 1967 and 1979. The relationship between birthweight and self-reported health outcomes were studied using multivariable logistic regression. In the full sample (n= 7840), birthweight was negatively associated with risk for nearsightedness (odds ratio OR = 0.76, 95% CI: 0.65 – 0.92) and minimal brain disorder (OR = 0.27, 95% CI: 0.16–0.44) when adjusted for gestational age, sex, zygosity, age, education and body mass index after correction for intraclass correlations and multiple comparisons. Within-pair analysis of 159 MZ and 224 DZ pairs revealed that myopic twins were on average 2 g (p= .966) and 64 g (p= .040) lighter than nonmyopic twins in MZ and DZ pairs respectively, suggesting that genetic factors may play an important role in the associations between birthweight and nearsightedness. Within-pair analysis of twins discordant for a minimal brain disorder indicated that affected twins were 80 g (p= .655) and 85 g (p= .655) lighter than their healthy co-twins in MZ and DZ pairs respectively, although there were only 2 MZ and 2 DZ discordant pairs.