To identify a suitable substrate for an oral rehydration solution (ORS) at home, this study evaluated the efficacy and safety of cassava-salt suspension (CSS) prepared from a dietary staple, cassava, with added sodium chloride. The results were compared with those of standard World Health Organization (WHO) recommended ORS. One hundred thirty-two dehydrated children aged between 6 and 24 months with acute diarrhoea of less than 3 days duration were chosen for the study and randomly rehydrated with CSS or WHO-ORS. The intake of ORS (CSS or WHO-ORS), water, and food was comparable in both groups. The mean stool output on day 1, total stool output, and duration of diarrhoea were 45.3 +/- 37.3 g/kg, 60.8 +/- 58.9 g/kg, and 18.9 +/- 22.4 h for the group on CSS. These are significantly different from the corresponding values of 69.7 +/- 64.9 g/kg, 88.2 +/- 100.4 g/kg, and 28.2 +/- 27.0 h obtained for controls. Failure of therapy occurred in four children on CSS (6%) and three children on WHO-ORS (4.5%). It is concluded that CSS is both efficacious and safe for use as an ORS, particularly in the home management of acute diarrhoea in children.