Severe anaemia in childhood is associated with increased mortality, although evidence relating moderate anaemia to child survival is scarce. We aimed to investigate this association. We did a case-control study of children with moderate anaemia, and compared haemoglobin concentrations measured up to a year before death for 403 children (age range 28 days to 15 years) with those from children who survived (matched for age and sex). Data were obtained from long-term health records (1950-97) of a rural Gambian research centre. Excluding an acute effect in this last week of life, no evidence was recorded of lower haemoglobin concentrations in the children who died than in survivors, or of any general or disease-specific effects of non-severe anaemia (70-110 g/L) on mortality.