Aim: to examine the impact of state-level access to basic environmental services and neighbourhood deprivation on under-five mortality rate Methods: Using data from most recent Nigeria Demographic and Health Survey for a sample of 6029 live births between 1999 and 2003 and exploratory spatial data analyses, the study analyzed the state-level association between environmental, neighbourhood deprivation and under-five mortality rate. Results: The spatial distribution of rates of under-five mortality rate was non-random and clustered with a Moran's I = 0.654 (p = .001). Spatial clustering suggested that North-east and North-west can be group as under-five mortality "hot-spot", and South-west, South-south, and South-east can be group as under-five mortality "cold-spot". The results outlined seemingly consistent finding that access to safe water, proper sanitation, and low pollution cooking fuel are important factors that can increase the chances of child survival. Conclusion: The maps could be used by policy makers for targeting development efforts at a glance for resource allocation and scaling up preventive efforts to achieve Millennium Development Goal, MDG-4 to reduce by two-thirds, between 1990 and 2015, the under-five mortality and MDG-7 to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Multifaceted geographically differentiated intervention may represent a potentially effective approach for addressing issues related to child survival.