This follow-up observational study examined gender disparities in seeking healthcare and in home management of diarrhoea, acute respiratory infections, and fever among 530 children (263 boys and 267 girls) aged less than five years in a rural community of West Bengal, India, from June 1998 to May 1999. Of 790 episodes detected by a weekly surveillance, 380 occurred among boys and 410 among girls. At the household level, girls were less likely to get home fluids and oral rehydration solutions (ORS) during diarrhoea. Qualified health professionals were consulted more often (p = 0.0094) and sooner for boys than for girls (8.3 +/- 4.5 hours vs 21.2 +/- 9.5 hours), for which parents also travelled longer distances (3.3 km for boys vs 1.6 km for girls). Expenditure per treated episode (Rs 76.76 +/- 69.23 in boys and Rs 44.73 +/- 67.60 in girls) differed significantly (p = 0.023). Results of logistic regression analysis showed that chance of spending more money was 4.2 [confidence interval (CI) 1.6-10.9] times higher for boys. The boys were 4.9 (CI 1.8-11.9) times more likely to be taken early for medical care and 2.6 (CI 1.2-6.5) times more likely to be seen by qualified allopathic doctors compared to girls. Persistence of gender disparities calls for effective interventions for correction.