Introduction: Level of development in health and nutrition at district level is useful for planning intervention in less developed districts. Aims & Objectives: to develop composite index based on 12 variables to compare development within districts in the state of Madhya Pradesh. Material & Methods: Data collected by National Institute of Nutrition, Hyderabad during 2010-11 on nutritional status of rural children at district level in Madhya Pradesh was used. A total of 22,895 children (Boys: 12379, Girls: 10516), were covered. Results: It was observed that Indore district rank 1st as per composite index and Singrauli rank last in the district ranking. Three categories of districts were done based on percentile of composite index i.e less developed, developing and developed districts. It was observed that there was significant (p<0.01) trend in the prevalence of undernutrition among three set of districts. Similarly, significant (p<0.01) trend was observed in proportion of children participating regularly in ICDS supplementary feeding programme, use of sanitary latrine and iodized cooking salt among three sets of districts. Conclusions: Widespread disparity in health and nutrition was observed among the districts. It is quite important to examine the extent of improvements needed in different developmental indicators for enhancing the level of development of low developed districts. This will help the planners and administrators to readjust the resources for bringing about uniform development in the state