Objective: Low-income children are routinely screened for anaemia and elevated blood lead levels (EBLL) but not for vitamin D deficiency. We sought to determine the relative prevalence of and the relationship among vitamin D deficiency, anaemia and EBLL among healthy low-income paediatric clinic patients. Design: Retrospective chart review. Setting: Paediatric outpatient clinic in an urban safety net hospital in a northern US state. Subjects: Healthy toddlers and children under 6 years of age (n 127) who were seen for a routine well child check-up (WCC). Results: The prevalence of vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) , 30 ng/ml) was 62 %; the prevalence of vitamin D deficiency (25(OH)D , 20 ng/ml) was 29 %. These rates were far higher than those for anaemia (Hb , 11?0 g/dl) at 10 %, EBLL (Pb . 9 mg/dl) at 1 % or even mildly EBLL (Pb 5-9 mg/dl) at 4 % (range: 1-11). There was no relationship among any of the following: vitamin D status, anaemia or EBLL. The vast majority of children with vitamin D deficiency had both normal Hb (86 %) and Pb level (100 %). After controlling for child's age, gender and race/ethnicity, there was no association between Hb (continuous, g/dl) and vitamin D deficiency (adjusted OR (aOR) 5 0?97, 95 % CI 0?64, 1?47; P 5 0?88). The only significant predictor of vitamin D deficiency was increasing age in years (aOR 5 1?39, 95 % CI 1?03, 1?86; P 5 0?03). None of these associations changed materially when deficiency was defined as ,15 ng/ml. Conclusions: Vitamin D deficiency was far more common than anaemia or EBLL, and Hb and Pb status were not predictors of vitamin D status.