The present paper provides an overview of rural- urban differences in health outcomes. The study explained the relevance of rural urban variations and deal with the determinants of rural - urban health variation. It tried attempting to examine the rural-urban Differentials across the major states of India. To investigate the rural -urban Differentials for this purpose, Twenty States have been considered. This analysis has been restricted only within child health, therefore only IMR has been taken into account. The study deals with the rural - urban trend in IMR and made a composite index of Health Determinants on the basis of health outcomes variables, by using the principal component analysis for major twenty states of India. It is quite evident that in case of IMAL, there exists much difference between the rural and urban areas in almost all the states. The states which have done well in urban areas have also performed well in rural areas. For the southern states namely Kerala, Karnataka, Tamil Nadu and Andhra Pradesh have really done well in IMHC, Goa’s performance in this index is also very commendable. As usual, EAG states lag behind the other states in IMHC in both rural and urban areas.