This paper examines the separate impacts of early childhood nutrition and current health problems on academic achievement. Previous research has only considered either the impact of nutrition or specific health problems on academic achievement. This is the first paper to consider both measures of health in a comprehensive way. A unique cross-section dataset of grade 4 students in Sri Lanka allows one to creatively deal with endogeneity issues stemming from missing variable bias. Specifically, controlling for school heterogeneity and parental taste for education the results show that children affected by hearing problems, intestinal worms and early childhood malnutrition have significantly lower cognitive skills. These results are robust to conditioning on the rate of student absence from school. The policy implications are that returns to investments made to improving school quality will be limited by any lack in investment in improving early childhood nutrition and health problems faced by children in school years.