BACKGROUND Vitamin A deficiency (VAD) is one of the three major micronutrient deficiencies in the world. In order to investigate the status of VAD and child feeding in China, we conducted the survey in Beijing city and Guizhou province. METHODS We included a high socioeconomic area (Beijing) and a low socioeconomic area (Guizhou province) in China in our study. Participants included 1236 randomly selected children aged 0-71 months from stratified clusters (628 in Beijing and 608 in Guizhou), 409 from urban and 827 from rural areas. A food intake frequency questionnaire was used for dietary assessment. Fluorescence microanalysis was carried out to measure serum retinol concentrations. Serum retinol cut-off values of less than 20 microg/dl and 30 microg/dl were defined as sub-clinical VAD and suspected sub-clinical VAD, respectively. RESULTS No xerophthalmia or night blindness was found. The mean concentration of serum retinol was 31.5 microg/dl in the high socioeconomic group, and 26.5 microg/dl in the low socioeconomic group. Rural infants had lower concentrations of serum retinol compared with the urban ones (26.9+/-8.1 microg/dl vs 31.8+/-7.3 microg/dl). The prevalence of sub-clinical VAD among all the children was 7.8%, and increased to 15.7% in children from the low socioeconomic group. In infants from the high socioeconomic area, the prevalence of suspected subclinical VAD was 38.0%, increasing to 59.5% in infants from the low socioeconomic area. The children from the low socioeconomic area had significantly lower fequency of intake of meat than the children in other groups. The prevalence of suspected sub-clinical VAD was higher in the children with lower consumption frequency of vitamin A rich foods than the children with higher consumption frequency of vitamin A rich foods. CONCLUSIONS VAD appears to be a moderate public health problem in certain areas of China. In areas with low socioeconomic status, VAD in childrean is more severe, and infants may be the group at the highest risk for VAD. Inadequate intake of vitamin A rich foods may result in VAD. A comprehensive long-term national strategy needs to be fostered in China for the treatment and prevention of the deficiency.