In developing countries, heavy workloads of women adversely affect their nutritional status and that of their children. Little is known, however, about the effect of children's heavy workloads on their own well-being. In Nepal, girls are expected to help their mothers in time-consuming and energy-demanding tasks from an early age. The aim of this study was to compare work patterns and anthropometric status of boys and girls age 6-17 years in western rural Nepal. It was hypothesized that girls would work longer and harder than boys and would have poorer growth status. It was also anticipated that children's work patterns might differ between highland and lowland areas. Two study sites were therefore chosen: one in the hills and the other in the lowland terai. A time allocation study was conducted for 237 children. They were observed continuously from 7:00 AM to 7:00 PM to determine the time spent in light, moderate, and heavy activities. Body weights and heights were also measured. On average, girls worked twice as long as boys (5.8 vs. 2.8 h/day, P < 0.001) and undertook more heavy work (1.5 vs. 0.7 h/day, (P < 0.001), but they did not have poorer anthropometric status. Children in the hills worked longer hours and did heavier work than those in the terai and were more stunted in growth.