Background: Zinc deficiency during the first 1000 days of life can crucially impact the health outcomes, especially among children in urban slums, where risk of undernutrition and infectious disease are high. Children in rural areas may face even higher risk of deficiency due to a low intake of animal-based foods. Poor dietary diversity and inadequate consumption of eggs and flesh food have been associated with unfavorable growth outcomes and increased risk of micronutrient deficiencies, particularly zinc. Our objectives were to: 1) Determine the prevalence of zinc deficiency and examine the longitudinal association between zinc status and health outcomes; 2) Examine the correlates of plasma zinc concentration and growth, morbidity, and socioeconomic factors; and 3) Determine the prevalence of zinc deficiency and examine the association of zinc status and dietary diversity among children 6-24 months old reside in urban slums, rural, and urban India. Methods: This secondary data analysis utilized sociodemographic, anthropometry, morbidity history, dietary, and biomarkers data from children in two parent randomized controlled trials conducted in urban slums and a rural area India, along with data from the Comprehensive National Nutrition Survey (CNNS) of India. Results: Zinc deficiency prevalence was relatively low among children in urban slums in Mumba. Over nine months, plasma zinc concentration (PZC) was positively associated with changes in arm-circumference Z-score (ACZ) and increased CD4 and CD8 cell counts, while inversely associated with the CD4/CD8 ratio. In a rural Andhra Pradesh, all children exhibited sufficient zinc status, and PZC was associated with height-for-age Z-score (HAZ). Across 30 states in India, zinc deficiency was more prevalent in rural (21.73%) than urban (14.67%) areas. Among rural children, consumption of foods from the grains, roots, tubers, and plantains food group was negatively associated with serum zinc concentration (SZC), whereas consumption of breastmilk, pulses, nuts, and seeds were positively associated with SZC and lower risks of zinc deficiency. Conclusion: Children aged 6-24 months are particularly vulnerable to zinc deficiency. The burden in high-risk population such as those in urban slums and rural areas was associated with immune and growth parameters and dietary patterns. Further studies are warranted to explore residence area as a non-modifiable risk factor to inform targeted, nutrition focused intervention addressing zinc deficiency among young children in LMICs.