Aims: Childhood illnesses such as diarrhoea and pneumonia remain major contributors to child mortality globally and need to be continually targeted in pursuit of universal health coverage. This study analyses time trends in the prevalence of fever/ cough and diarrhoea in Nepal and applies an equity lens in order to identify disadvantaged groups. Methods: Data from the Nepal Demographic Health Surveys of 2001, 2006, and 2011, together with data from the most recent Multiple Indicator Cluster Survey of 2014 performed in Nepal, were utilized for analysis. Results: Analyses revealed improvements (lower prevalence) of diarrhoea and fever/cough in children under five in Nepal over the last 15 years, with an equitable distribution of symptoms over socio-economic determinants. There was, however, a marked and maintained inequity in care seeking for these symptoms, with less educated mothers and those from poor households being only approximately half as likely to seek care for their children. Conclusions: Results highlight the persisting need for targeting care seeking and societal barriers to treatment in order to achieve universal health access.