To determine the frequency of early deaths and the associated risk factors in children suffering from cancer at the University College Hospital, Ibadan. A retrospective study involving review of case notes of children suffering from cancer. Department of Paediatrics, University College Hospital, Ibadan, Nigeria. All cases of childhood cancer managed in the Department between January 1998 and December 2004. Inclusion criteria were histological or cytological confirmation of diagnosis, suggestive clinical features and availability of details about the course of the illness. Interval between diagnosis and death, rate of early death (death within 30 days of diagnosis) and risk factors for early death. Eighty eight cases of childhood cancer were seen out of whom 52 died during the period. Four cases with incomplete data were excluded from subsequent statistical analysis. There were 29 (34.5%) early deaths defined as death within 30 days of diagnosis. The odds of early death were increased in the presence of bilateral kidney involvement, masses in the liver, splenic masses, pulmonary metastasis and stage D of Burkitt lymphoma. Logistic regression analysis revealed that pulmonary metastasis was a significant independent predictor ofearly death. Early childhood cancer mortality rate is high. Early diagnosis and referral for appropriate care may reduce childhood cancer mortality in Nigeria.