This study reports the first analysis of mortality differentials in Nepal. Longitudinal survey data collected from four districts indicate infant mortality was lower and child survival higher in the hill than in the plains (Terai) region, but that the differential narrowed between 1975 and 1978. In addition, child survival varied directly with education and landholdings within both regions. Possible explanations for the findings include the presence of vertical and integrated family planning and maternal and child health programmes and differential access to and utilization of health care and health facilities.