Background The Thrive by Five Index 2024 represents South Africa’s most comprehensive effort to date to assess the developmental status of 4-year-old children across the country. Grounded in the Nurturing Care Framework for Early Childhood Development [3], the 2024 Index offers a detailed, nationally representative snapshot of how children are faring in the critical domains of early learning, physical growth, and social-emotional development. This second round of the Thrive by Five Index builds on the inaugural 2021 Index, expanding the scope and methodological rigour. It also introduces a sub-study of non-enrolled children - to shed light on the realities of children not attending Early Learning Programmes (ELPs). Key Findings Only 42% of enrolled children are developmentally On Track in Early Learning (as measured by the ELOM 4&5), with notable differences by gender and socio-economic circumstances. Girls outperform boys across all learning domains (except Gross Motor Development), and children in Higher Fee ELPs significantly outperform those in Lower Fee ELPs. Across the domains, the strongest performance was in Emergent Literacy and Language (53% of children were On Track), followed by Gross Motor Development (44%), Cognition and Executive Functioning (40%), Emergent Numeracy and Mathematics (33%), and Fine Motor Coordination and Visual Motor Integration (29%). Approximately 7% of enrolled children show signs of moderate or severe stunting. Overall, 56% of children Meet the Standard for Emotional Readiness, while 63% Meet the Standard for Social Relations with Peers and Adults. Girls are more likely than boys to Meet the Standard in both areas. Statistical modelling found that Task Orientation - children’s ability to concentrate, persist, and show interest (observed and rated during the child assessments) - was the strongest predictor of learning outcomes, followed by their emotional functioning and socio-economic circumstances. Growth status (children’s height-for-age) was also significantly associated with learning outcomes, but with a modest effect size. The sub-study highlighted severe developmental deficits among non-enrolled children, with a massive 82% of non-enrolled children Falling Behind or Far Behind on early learning. Rates of stunting were exceptionally high - 18% of the non-enrolled children showed signs of moderate to severe stunting. The deprivation observed within the non-enrolled sample points to profound levels of vulnerability. Although this sample is not representative of non-enrolled children nationally, it underscores the importance of gaining a deeper understanding of this population to meet their needs more effectively.