Abstract Objective In the past decade, Vietnam has achieved an impressive rate of socioeconomic development paralleled by broad improvements in the health sector – but child malnutrition still lags far behind that of most other health indicators. The purpose of this study is to discover inequality in the near-present situation (1997–98; hereafter referred to as the present situation), changes of child malnutrition over the period from 1992–93 to 1997–98, and factors that might affect the inability to rapidly reduce child malnutrition among the poor, rural, and minority populations. Design Data from two nationally representative surveys – the 1992–93 and 1997–98 Vietnam Living Standards Measurement Surveys (LSMS) – of Vietnamese households were utilized in this study. Descriptive and logistic procedures were used for the analyses. The focus was on the variables related to household poverty status, total expenditure levels, rural residence, and minority status with controls for other key economic and demographic measures. Subjects A cross-sectional analysis was conducted on data using 4305 households and 4367 children (2–11 years of age in 1992–93) that were included in both surveys of the Vietnam Living Standard Survey (VLSS) in 1992–93 and 1997–98, conducted under the framework of the LSMS. Results Children of rural households, poor households, and ethnic minority backgrounds are significantly more likely to be malnourished than urban residents, children of nonpoor households, and the majority Kinh population. Additionally, avenues to escape malnourishment are limited in the former categories. These results suggest that economic improvements in Vietnam have, for the most part, bypassed the rural poor and minorities, and targeting economic resources towards these groups will be most critical to reduce malnutrition in Vietnam.