Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Af- rica. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups—as in Côte d’Ivoire, Kenya, and Niger—these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state con- trol, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda have experienced much lower mortality than oth- ers. In most countries, the lower mortality of potent ethnic groups—who typically represent small proportions of national populations—is strongly related to economic privilege. Persistent inequalities among African eth- nic groups deserve strong consideration in planning economic develop- ment and child health strategies