Background: The increasing prevalence of childhood obesity is a global problem. Childhood obesity is associated with an increased risk of several metabolic complications such as insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus (T2DM). Moreover, childhood obesity plays a significant role in growth patterns. Current Concepts: Growth during childhood and adolescence is influenced by multiple factors, including genes, hormones, and environmental aspects. Excess adiposity can influence growth velocity and final adult height owing to changes in several hormonal parameters such as insulin, leptin, and ghrelin. Discussion and Conclusion: Obese children typically exhibit a tall stature during the prepubertal and pubertal periods, which resolves later in adolescence. In addition, increased obesity in children precedes advancements in skeletal maturation and leads to earlier onset of puberty. Although potential mechanisms have been hypothesized, those underlying the putative association between childhood obesity and growth remain unclear. Further studies are required to gain insight into the mechanisms underlying the growth patterns in children and adolescents with obesity.