This paper extends the empirical analysis of child health by simultaneously considering the effects and contributions of parental bargaining to the rural-urban child health differential in Tanzania, a country where most communities are patriarchal in nature. The study uses the Heckman two-step procedure to correct for possible sample selection bias. The results suggest that domestic violence towards female partners increases the probability of child stunting while cooperation in decision-making between couples and female discretion over household resources reduces the probability of child stunting. The signicance of these effects are mainly observed in rural than in urban communities. Differences in parental bargaining account for 5 percent of the rural-urban gap in child nutrition. Correcting for sample selection bias reduces the contribution to 4 percent. The findings suggest that empowering rural women is essential in reducing the rural-urban child health differentials.