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To investigat the association between paternal age at birth and offspring's under-5 mortality in low- and middle-income countries (LIMCs). Data from 159 population-based surveys in 67 LIMCs between 2000 and 2018 were obtained from the Demographic and Health Surveys. Cox proportional hazard regression models in consideration of complex survey design were performed to examine the associations. In the pooled analysis, compared with children born to fathers aged 25-29 years, those born to younger fathers aged 20-24, 16-19 and 12-15 years, r