The prevalence of eye signs and symptoms of vitamin A deficiency was determined among 29,615 Sudanese children between 6 and 72 mo of age, in five rural areas of Khartoum and Gezira provinces. Of all children, 2.9% were vitamin A deficient, and of these > 90% had Bitot's spots. Bivariate associations were found between xerophthalmia and the rural councils where the children lived, household wealth, consumption of vitamin A-containing foods, child sex, child age and weight-for-height Z-scores. Multivariate analysis showed that the following factors made significant independent contributions to the risk of xerophthalmia: living in remote and arid regions, male gender, age, poverty of the household, and prevalence of diarrhea. On the other hand, less xerophthalmia was observed among children who during the 24 h preceding the survey had consumed dairy products or non-leafy vegetables containing vitamin A. Intervention programs aimed at increasing household income and promoting consumption of foods containing vitamin A should contribute to the reduction of vitamin A deficiency among Sudanese children.