This prospective 20-year follow-up study contrasts the development of a group of 20 children grossly undernourished during infancy (index group) with that of a matched control group. There were significant differences between two groups in head circumference, height, weight, full-scale IQ, verbal quotient, non-verbal quotient and in visuo-motor perceptual function. Despite their disadvantages, the index group have integrated effectively into the community, and their children have not experienced the nutritional deprivation they suffered during their own childhoods.