Background: Case based measles surveillance in Nigeria today is very poor and as such there has been a failure to recognize and react to the prevalence of the disease among children less than 9 months old: the earliest age of vaccination against the disease in Nigeria. Objectives: to describe the occurrence and fatality of measles in the pre-vaccination age group in Ibadan. Study Design: A retrospective cohort study at the Oni Memorial Children’s Hospital, Ibadan between Jan 2004 and Dec 2005. Results: A total of 346 suspected measles cases were seen within the 2 year period of the study. 183 (52.9%) were males and 163 (47.1%) were females. 39 (11.3%) of the children were below 9 months. 40 (11.6%) of the patients admitted died during that admission, while 304 (88.4%) were discharged alive, absconded from the hospital or were referred for further management. The case fatality for the 0-8 month group was 5.13% while for the above 9 month age group was 12.46%. The hazard of dying from measles in the above 9 month age group is 2.43 times that for the 0-8 month age group.