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Objectives: To compare the prevalence of iron deficiency among Ghanaian children in different residential settings and to see whether 200mg ferrous fumerate B.P. could correct iron deficiency anaemia in observed cases of iron deficiency., Design: Prospective case-finding study using an iron-deficiency society questionnaire, laboratory data and general practice records. Crude prevalence was calculated using the hospital's mid-year estimates., Setting: Nkoranza in the Brong Ahafo Region of Ghana, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Subjects: Rural-dwelling children entering as out-patients, urban-dwelling children entering as controls and newly diagnosed iron-deficient children entering as in-patients., Main Outcome Measures: Crude prevalence rates (per quinquennia) for three groups of children. Corrected deficiencies expressed as percentage after management. Age, haemoglobin, iron status, residential status, symptoms at entry and after therapy., Results: Following a 30-day administration of ferrous fumarate, the mean serum iron for the rural children increased significantly by 3.3 micromol/l representing an improved iron status of 20.0%(P<0.0001). Iron deficiency anaemia defined by serum Hb<12.0 g/dl and Fe<12.5 mmol/l decreased by 10% in the rural subjects. Comparatively, iron deficiency among the newly diagnosed anaemia group, fell by 17.6% whilst their ambulant urban counterparts employed as the control group had an iron deficiency anaemia of 0.0%., Conclusion: The study clearly indicates that the-prevalence of iron deficiency anaemia among children in rural Ghana is about ten times that of the urban-dwelling children and that iron-deficiency anaemia accounts for a greater percentage of all anaemic cases among children in our hospitals. It was also shown that taking appropriate iron supplements like 200 mg of ferrous fumerate for thirty days can substantially improve the iron status of iron-deficient children.