ObjectiveTo examine the trends in prevalence of overweight and obesity, as well as the impact of stunting on overweight/obesity, among rural children aged <60 months in southeast China between 1998 and 2005. Study designData from the population-based Child Health Care Surveillance System (CHCSS) from eight counties in southeast China were used. Overweight and obesity were defined as weight-for-height/length z score >2 and >3 standard deviations (SDs), respectively, and stunting was defined as height/length-for-age z score <−2 SD, in accordance with the 2006 World Health Organization growth standard. MethodsA total of 550,693 clinic visit records of 280,931 children from the CHCSS, collected between 1998 and 2005, were included in the analysis. The age- and sex-adjusted prevalence rates of overweight, obesity and stunting were estimated for each year, and the trends over time were examined. The impact of stunting on overweight/obesity was determined using multiple logistic regression analysis. ResultsThe prevalence of overweight increased from 3.7% in 1998 to 3.9% in 2005 (P < 0.001), but no increase in the prevalence of obesity was observed (0.5% in 1998 and 0.6% in 2005; P > 0.05). The prevalence of obesity increased significantly in 2005 compared with 1998 among boys aged ≥24 months, but was similar between 1998 and 2005 for girls aged ≥12 months. The prevalence of stunting decreased from 3.9% in 1998 to 1.6% in 2005 (P < 0.001). There was a positive association between stunting and overweight/obesity in both 1998 and 2005, although the association was attenuated in 2005. ConclusionThere was a small increase in the prevalence of overweight among rural preschool children in southeast China from 1998 to 2005. The prevalence of obesity remained stable. However, the prevalence of stunting decreased and its positive influence on overweight/obesity was weaker in 2005.