Although agriculture is now the globally predominant mode of food production, studies of the skeletal remains of early agriculturalists have indicated high levels of physiological stress and poor health relative to hunter-gatherers in similar environments. Previous studies identifying this trend in different regions prompt further research of the causes and effects of subsistence transitions in human societies. Here, 242 dentitions from five ancient Egyptian and Nubian populations are examined: 38 individuals from Jebel Sahaba (Upper Paleolithic), 56 from Badari (Predynastic), 54 from Naqada (Predynastic), 47 from Tarkhan (Dynastic), and 47 from Kerma (Dynastic). These populations span the early period of agricultural intensification along the Nile valley. Skeletal remains were scored for the presence of linear enamel hypoplasia (LEH) of the dentition, an established indicator of physiological stress and growth interruption. The prevalence of LEH was highest in the “proto-agricultural” (pastoralist) Badari population, with a gradual decline throughout the late Predynastic and early Dynastic periods of state formation. This suggests that the period surrounding the emergence of early agriculture in the Nile valley was associated with high stress and poor health, but that the health of agriculturalists improved substantially with the increasing urbanization and trade that accompanied the formation of the Egyptian state. This evidence for poor health among proto- and early agriculturalists in the Nile valley supports theories that agricultural intensification occurred as a response to ecological or demographic pressure rather than simply as an innovation over an existing stable subsistence strategy. Am J Phys Anthropol, 2007. © 2007 Wiley-Liss, Inc.