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In 1900, the child mortality rate in the area of present-day North Korea was estimated to be almost five hundred deaths per thousand live births, meaning that approximately half of all children born at this time were not expected to survive past their fifth birthday. This rate would increase to 524 deaths per thousand births in the 1910s, before rapidly falling from the 1910s until the middle of the century (following the Japanese annexation of the peninsula in 1910). There was a slight increase in child mortality rates in the late 1940s, as the Korean peninsula was divided into two states; although it continued upon its rapid decline in the 1950s, with the decrease slowing in the next three decades.

This decline would continue steadily until the 1990s, when the collapse of the Soviet Union and the resulting cut-off of economic aid would cause child mortality to rise for a decade, and this was exacerbated by the flooding, drought, famine and economic mismanagement of the late 1990s. The past two decades, however, have seen child mortality fall once more, and in 2020, it is estimated that for every thousand children born in North Korea, over 98 percent will make it past the age of five.