Although advances in neonatal care over the past century have resulted in increased rates of survival among at-risk births, including infants with low birth weight, we have much to learn about psychological outcomes in this population. In particular, despite growing evidence that low birth weight may be associated with an increased risk for Attention-Deficit/Hyperactive Disorder (ADHD) symptoms in childhood, few studies have examined birth weight as a risk factor for disruptive disorders that commonly co-occur with ADHD. In addition, the etiology of the relation between birth weight and these disorders is unknown. The current investigation aimed to better understand these associations in the context of potentially confounding genetic and environmental influences by examining phenotypic associations between birth weight and disruptive disorder symptoms both between families and within families in two independent twin samples (Sample 1: N = 1,676 individuals; Sample 2: N = 4,038 individuals). We found negative associations between birth weight and inattentive, hyperactive-impulsive, and broad externalizing symptoms in both samples. Nonetheless, the overall magnitude of these associations was very small, contributing to less than 1% of the variance in these symptom dimensions. Within-family associations between birth weight and disruptive disorder symptoms did not differ for monozygotic and dizygotic twin pairs, suggesting that nonshared environmental influences rather than common genetic influences are responsible for these associations. Overall, the consistent albeit weak associations between birth weight and disruptive disorder symptoms suggest that low birth weight may not represent a major risk factor in the development of these symptoms.