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New Zealand research on inequities in children’s developmental health outcomes is sparse. We aimed to describe the prevalence, clustering, and socio-environmental associations of developmental health in preschool-aged children. A latent profile analysis was performed using data from child participants of Growing Up in New Zealand at age 4.5-years to identify profiles of developmental health status. Seven measures were included in the latent profile analysis, representing four domains of developmental health: ‘physical’, ‘motor’, ‘socioemotional and behavioural’, and ‘communication and learning’. Multinominal logistic regression was used to investigate socio-environmental associations of latent profile membership. Six latent profiles were identified (N = 6109), including three healthy/flourishing profiles: ‘healthy’ (52.6% of the sample), ‘early social skills flourishing’ (14.5%), and ‘early learning skills …