This study compares the growth patterns of Saudi Arabian pre-school children aged 0-5 years to a reference population of American children documented by the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC). The anthropometric data of weight, height and age were collected in a cross-sectional study of Saudi Arabian children in Riyadh, the capital of Saudi Arabia. The sample selection was accomplished by a 3-stage stratified random procedure, basing the stratification on location and a socio-economic index. A total of 3,795 children comprising 55.2% males and 44.8% females had complete basic anthropometric measurements among other variables. Analyses were effected by using the WorHealth Organization/Centers for Disease Control (WHO/CDC) standard software programme for calculating nutritional indicators. A combination of height for age (as an indicator of stunting) and weight for height (as an indicator of wasting) showed that a sizeable proportion (78.1%) have normal or slightly above normal nutritional status. A small proportion of the children (1.4%) were below -2.0 SD scores of the reference population for weight for height and for age. Overall, Saudi Arabian children are slightly shorter and thinner than their American counterparts. An important finding in weight for height was that nearly 20% of the children were below -2 SD scores of the reference population median. However, due to the very high per capita income, and the fact that food and other essential items are subsidised by the government, the deficits from this reference population may be attributed to inadequate health education nutrition programmes, genetic and other social factors including reproductive behaviour, rather than malnutrition.