To examine the effects of stunting in early childhood on blood pressure in later childhood. A cohort study. Kingston, Jamaica. Seven to eight year old children, 120 stunted (height for age <-2 s.d. of the NCHS references) and 224 non-stunted (height for age >-1 s.d. of the NCHS references) at age 9-24 months. Stunted and non-stunted children were identified at age 9-24 months by house to-house survey of poor neighbourhoods in Kingston, Jamaica. Blood pressure and anthropometry were measured at age 7-8 y. Birth weight was obtained from hospital records (73%) or maternal recall. The stunted children remained shorter and thinner than the non-stunted ones. In multiple regression analysis adjusting for size and pulse rate, the stunted children had higher systolic blood pressure (P<0.05). Birth weight was not a significant predictor of systolic blood pressure. Stunting in early childhood may increase the risk of elevated systolic blood pressure in later life. Nutricia Research Foundation, The Netherlands and the Commonwealth Caribbean Medical Research Council.