The prevalence of malnutrition in Bangladesh remains among the highest in the world. Persistent malnutrition contributes not only to widespread failure toward meeting the first Millennium Development Goal (MDG) of halving poverty and hunger, it also undermines efforts to reach MDGs relating to material and child health, HIV/AIDS, education, and gender equality. The most important determinants of malnutrition need to be known in order to determine the most effective strategies for reducing malnutrition in Bangladesh. The Nutritional Surveillance Project (NSP) implemented by Helen Keller International (HKI) in collaboration with the Institute of Public Health Nutrition (IPHN) of the Government of Bangladesh collects household and village level data, every two months, from a nationally representative rural as well as urban poor sample on a comprehensive range of indicators, has provided key information for Bangladesh’s development efforts and 2002 data were analyzed to asses the relationship between malnutrition (stunting) and several immediate and underlying cause of malnutrition (stunting) and several immediate and underlying cause of malnutrition. Access to food is the most important immediate factor, among all socio-economic strata, that determines malnutrition level.