A 3-arm cluster-randomized trial was conducted that evaluated the efficacy of prenatal multiple micronutrient supplementation (MMS), lipid-based nutrient supplementation (LNS), as compared to routine iron–folic acid (IFA) supplementation among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019. Results demonstrated that there was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones.