Stereological methods were used to test whether or not altitudinal, ethnic and sex differences in birthweight in Bolivia are associated with differences in placental morphology. Estimates of the volumes, surface areas, lengths and diameters of villi and of fetal capillaries were obtained by analysing paraffin sections of tissue. The average highland placenta contains villi of smaller overall volume, surface area and length. These villi possess a less voluminous fetal vascular space, and the capillaries are smaller in mean diameter. The average Amerindian placenta has longer but thinner capillaries than the average placenta delivered by non-indigenous women. Altitude and ethnic grouping interact to have an effect on total villous length, whilst ethnic grouping and sex interact to influence fetal capillary length. These structural differences are discussed in the context of their likely impact on placental functioning, notably on exchange by passive diffusion.