Baseline findings of this nationally representative study reveal variations in nutritional status, household food security, agricultural production and practices, and sanitation between the agro ecological zones of Nepal. Undernutrition in under-five children and women was found to be consistently worse in the terai (with the exception of under-five stunting rates being approximately 36%). Household food insecurity was 40% across the PoSHAN sample during the May – July 2013 season; with terai households found to be least food insecure. The utilization of innovative agricultural practices were most common in the terai. Less than half of the overall sample owned toilets (48%) and only 14% of household in the terai owned one. Access to health and agriculture extension workers was noted to be low in the mountains, hills and terai (<10% and <6% respectively). These major findings highlight both a disconnect between increased production and access to food and undernutrition in women and children, as well as the significance of being specific when targeting communities to address the persistently high rates of undernutrition, food insecurity, hygiene and sanitation, access to decentralized healthcare and agricultural systems and overall promotion of innovative agricultural methods in Nepal.