Childhood palaeopathology remains an underutilised resource in the study of Roman Britain, particularly for exploring the lives of the rural population. Lesions in child skeletons provide unique insights into past lifeways and population health, as adverse environmental conditions translate more readily into the osteological record of these vulnerable members of society. To demonstrate the range of information gleaned from the children, 1,279 non-adults (0–17 years) from 26 first- to fifth-century urban and rural settlements were analysed, comparing morbidity and mortality in the most comprehensive study to date. The distribution of ages-at-death suggests migration between country and town, the latter presenting a stressful and unsanitary environment. However, as demonstrated by high rates of metabolic disease and infections, life in the countryside was hampered by demanding physical labour and potentially oppressive conditions with restricted access to resources.