OBJECTIVE: To verify if there are different patterns of nutritional status among preschool children, and if these patterns deserve special interventions. METHODS: This cross-sectional study included 1,200 children from public preschools in Cosmópolis, a small town in the state of São Paulo. The z scores indices for height/age, weight/age, and weight/height were analyzed in terms of age, sex, type of school, and school location. RESULTS: Anthropometric indices were similar to those of the reference population (NCHS). Males had lower indices than females. Important differences in anthropometric indices were found among children from different schools. Higher prevalence of moderate deficits in height and weight was observed in children from non-downtown areas, while higher prevalence of obesity was found in children from downtown areas. However, the prevalence of obesity was higher than the prevalence of malnutrition even in schools located in non-downtown areas. CONCLUSIONS: We concluded that even in a small city and in a relatively homogeneous group, it is possible to detect different nutritional patterns in subgroups of the population. The differences related to nutritional status, and the high prevalence of obesity among children from public schools, point out the need for different approaches and interventions.