【Objective】 To evaluate under five years old children′s physical growth and nutritional status by using Z score. 【Method】 Using stratified random sampling method 1 5930 children were measured height and weight and WHO Anthroplus 2007 was used to calculate Z score in 24 counties and 3 cities. 【Results】 The overall prevalence of stunting (HAZ<2), underweight (WAZ<2) and wasting (WHZ<2) were 11.41%(1 818/15 930), 7.06%(1 125/15 930) and 2.58%(411/15 930) respectively. They were higher in rural areas than urban. The prevalence of stunting in rural areas was 3.2 times than urban.The Z scores of HAZ, WAZ and WHZ were 0.96±1.08, 0.51±1.32 and 0.08±1.68 respectively. In urban they were 0.18±1.37, 0.19±1.12 and 0.52±1.11 respectively and in rural areas they were 1.23±1.40,0.63±1.21 and 0.12±1.24 respectively. It showed a tendency that Z scores of HAZ, WAZ and WHZ declined with increasing age. 【Conclusions】 Compare to WHO criteria, physical growth level of under five years old children in Hebei province is lower and have significant difference between urban and rural areas. In rural areas, the total nutrition of children is not enough.