Purpose: To evaluate signs and symptoms associated with the eruption of the primary mandibular central incisors in preterm and low birth weight (PLBW) children.<br/>Methods: A prospective longitudinal study was performed with 46 PLBW Brazilian children in a university hospital with a 10-month follow-up. Signs and symptoms of tooth eruption were recorded monthly by clinical examination and caregivers' report. Tooth eruption was categorized into "preeruption" (T0-no erupted crown/month before the eruption), "eruption" (T1-eruption of the tooth up to one-third of the crown/month of eruption), and "posteruption" (T2-from one-third of the erupted crown to completely erupted crown/month after the eruption). Bivariate statistics were performed (P <0.05).<br/>Results: The mean age in T1 was 11 months (±2.50 standard deviation). The symptoms most frequently reported in T1 were increased salivation and finger suction (44.2 percent). The mean number of symptoms in T1 was higher than in T2 (P <0.001). There was a higher frequency of irritability (P =0.022) and itching of the gingiva (P =0.004) in T1 than in T2.<br/> Conclusion: PLBW children presented signs and symptoms mainly in the initial phase of tooth eruption. Increased salivation and digital suction were the most common symptoms.