Objective: Thyroid dysfunction and hyperglycemia are common metabolic problem. Unrecognized thyroid dysfunction may amplify existing cardiovascular disease risk in hyperglycemic subjects. Early recognition and management of thyroid dysfunction helps to control blood glucose and prevent associated morbidity. The aim of this study was to assess thyroid function among prediabetics and compare it with healthy controls. Methods: This study conducted in Kathmandu University hospital was reviewed and approved by Institutional review committee. A total of 100 apparently healthy prediabetics (HbA1c 5.7-6.4%) along with 100 healthy controls (HbA1c < 5.7%) visiting the outpatient department for annual health screening were recruited. We excluded known cases of diabetes mellitus, thyroid disorder, pregnant and those on medications that interfere with thyroid function and/or glucose metabolism. Glycated hemoglobin (HbA1c) concentration was measured by high performance liquid chromatography (HPLC) method in ERBA Mannheim’s Hb-Vario. Serum was collected from all the participants and thyroid stimulating hormone (TSH) was measured by chemiluminescence assay (CLIA) using LIASION TSH assay (Diasorin). Results: Among the total participants 42.5% (85) were male and 57.5% (115) were female with mean age of 33.3 ± 7.3 years. The mean HbA1c level among prediabetics was 5.9 ± 0.09 while that of control was 5.2 ± 0.37. Prediabetics had significantly higher TSH 3.0 (2.0, 4.9) in comparison to the control 2.6 (2.0, 3.9) population (p < 0.001). The association between prediabetics and increased TSH was significant (p = 0.01) with 28% of prediabetics having increased TSH compared to 14% in normal group. The odds of having increased TSH among prediabetics was 2.38 times than that of controls at 95% CI (1.17, 4.17). Conclusion: Increased serum TSH is common finding among those with prediabeties. The cause of thyroid abnormality should be ascertained and treated appropriately to reduce the progression to diabetes mellitus and related complications. Though not routinely practiced, screening of thyroid disorder in patients with hyperglycemia could be beneficial.