Body mass index (BMI) is one of the anthropometric measurements for assessing nutritional status, body composition and adiposity in children. Racial differences in BMI between black and white children and adolescents have been shown in several studies. The aim of this study was to determine whether an ethnic difference in BMI exists between Chinese and Caucasian children in the first two years of life. The BMI of Chinese and Caucasian infants was compared so as to assess the usefulness of the National Center for Health Statistics (NCHS) growth reference data in the assessment of nutritional status of Chinese children. Mean weight, length and BMI were compared between six cohorts of Chinese children and five cohorts of Caucasian children together with the NCHS growth reference data. The changes in the mean BMI curves during the first two years of life in the two ethnic groups were entirely different but the different cohorts in the same ethnic groups displayed a similar pattern of change with age. The difference in change in BMI in the Chinese cohorts was related to the difference in change in their mean weight as compared to the NCHS weight-for-age reference data. In contrast, the change in mean length of the well-nourished Hong Kong Chinese children in the present study followed the mean NCHS height-for-age values. The results of this study suggest that linear growth would be better for the assessment of health and nutrition in infancy and early childhood. If BMI and weight-for-height standards were to be used then an ethnic group-specific and population based reference data set should be used.