This study examines spatial patterns in infant and under-five mortality rates in India at the levels of NSS-regions and Census-districts. We find significant spatial correlation both at the national and local level meaning that both global and local environment influences the mortality rates. We identify Assam-East as a spatial outlier. Besides, there exist several hot- and cold-spots in the country. The study further examines determinants of under-five mortality using spatial regression models. Contrary to the existing evidence, we find neither female labor force participation nor general level of modernization help reducing under-five mortality significantly. However, we find importance of reducing poverty, improving provisioning of public health interventions like antenatal care to women and immunization of children, and educating women. Integrating health awareness with health policy might be helpful in improving health outcomes. Using OLS without adjusting for spatial heterogeneity may lead to biased and inefficient parameter estimates.