Background: Many developing countries now are facing the problem of double burden of malnutrition, defined as the coexistence of undernutrition and overweight/obesity within the same household/population. Malnutrition among under-five children is an important public health problem causes premature morbidity and mortality in developing countries including India.

Objectives: The present investigation assesses the prevalence of thinness and at risk of overweight, overweight and obesity among tribal pre-school children (<5 years) of Assam, Northeast, India.

Material and Methods: This cross-sectional investigation was conducted among 360 (170 boy and 190 girls) Sonowal Kachari tribal pre-school children aged <5 years of North Lakhimpur district of Assam, India. Anthropometric measurements of length/height and weight were recorded using standard procedures and age-sex specific BMI-for-age z-score (BMIAZ) were calculated using WHOAnthro Software. A child found to be <−2.00 BMIAZ was classified as thinness and BMIAZ>+1.00, >+2.00, >+3.00 are used to define at risk of overweight, overweight and obese, respectively.

Results: The overall prevalence of thinness, risk of overweight, overweight, and obese were found to be 11.66%, 12.22%, 6.66% and 3.00%, respectively. However, sex-specific prevalence was found 7.05%, 10.58%, 8.23% and 1.76% (in boys) and 23.07, 11.57%, 5.26% and 4.21% (in girls).

Conclusion: This investigation confirms a coexistence of under- and over-nutrition among the Sonowal Kachari population. There is a need for an urgent target-specific intervention program for improvements of nutritional status, contributing to reduce the burden of child undernutrition and planned strategies to overcome the double risk factor of overweight and obesity in the population.