The Purpose of the present study was to study the prevalence of iron deficiency and iron deficiency anemia (IDA) in children aged 1- to 3-years in a high altitude urban population in AL-Taif city in Saudi Arabia. Three hundred seventy two 1 to -3 year-old children examined during their well-child visits in 2 big hospitals were enrolled. Children with histories of chronic illness, blood dyscrasias, prematurity or with a current febrile illness were excluded. Venous blood was measured for levels of hemoglobin, serum ferritin, free erythrocyte protoporphyrin and lead. About half the children (49.5%) demonstrated evidence of iron insufficiency, 18% were iron deficient without anemia and 8.9% were found to have IDA. We concluded that supplemental iron should be recommended during the second year of the life especially in toddlers living at high altitude.