This study compares the mortality rates of children in Taiwan with selected industrialized countries, and identifies the explanations of cross-national variations. We ranked all comparison countries by infant mortality rate (IMR) and under-five mortality rate (U5MR). Multiple regression models were used to examine the relationship of child mortality with gross domestic product, national health expenditure, public social expenditure, and Gini coefficient. For 2002, the IMR and U5MR in Taiwan were 6‰ and 8‰, respectively, both ranking 20th among 21 industrialized countries. In explaining cross-national differentials in child mortality, we found that Gini coefficient, an indicator of income inequality, was positively associated with IMR and U5MR, and that social expenditure was negatively associated with U5MR. Our study shows that prevention of child mortality in Taiwan has not yet reached the highest attainable standard, and underscores the importance of a fairer income distribution and social investment in child health care. [J Formos Med Assoc 2007;106(2):177-180]