Background. This investigation aims to determine and analyze the evolution and the main features of the mortality rate in children aged one to four years in Costa Rica, from 1920 to 2009. Methods. We calculated the mortality rate of children aged one to four years for each year and for each five-year period from 1920 to 2009. We used the population of 1-4 year olds as the denominator. The percent contribution of such deaths to overall mortality in Costa Rica was also calculated. Moreover, we determined the mortality rate for each province and finally, the main causes of death in this age-group for three different years. Results. From 1920 to 2009, the mortality rate per thousand children of the age group decreased by 99.1%. When analyzed by quinquennia, there was a 98.2% drop between 1920-24 and 2005-09. As for the percentage contribution of the mortality of 1-4 year olds to overall mortality, the highest percent contribution occurred in the 1935-39 (19,49%). Between 1920-24 and 2005-09, there was a 96,7% decrease in the percent contribution. Conclusions. There was a very significant decline in the mortality rate of children aged 1 to 4 years in Costa Rica between 1920 and 2009. This represents an enormous public health achievement in this country; the rate declined by at least 98%, as did infant mortality and mortality of children under five years of age. The percent contribution of the mortality of this age group to overall mortality also decreased in a similar magnitude.

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