Abstract: Objective:To investigate the deviation of physical growth status of children with autism spectrum disorder (ASD). Methods:Data were collected from the specialty medical record database of ASD diagnosed by qualified developmental behavior specialists from Children's Hospital of Fudan University from January 2016 to August 2019. The data were collected from routine physical measurement at the time of suspicion for (<2 years old) and diagnosis of ASD. Children with suspected ASD were followed up to be diagnosed at the age of 2. Anthropometric parameters (weight, length/height, BMI) were converted to Z-scores for age using the WHO Anthro. BMI Z-score > +2 SD refers to obesity, and BMI Z-score < -2 SD refers to emaciation. Obesity and emaciation together are defined as deviation. Influencing factors of physical growth deviation were analyzed. Results:A total of 511 consecutive ASD samples from the ASD medical record database were analyzed, including 420 cases (82.2%) aged 1 to 4 and 91 cases (17.8%) aged 5 to 8. There were 431 males and 80 females. The proportion of obesity in all included ASD patients and the group of 1-4 years old was higher than that of emaciation (P<0.05). There was no significant difference between the ratio of obesity and emaciation in the group of 5-8 years old. There was no significant difference in obesity and emaciation ratio between boys and girls with ASD. The incidences of growth deviation and emaciation in the group of 5-8 years old were 3.3 times (95%CI: 1.81-6.00) and 5.64 times (95%CI: 2.22-14.31) higher than that in the group of 1-4 years old. Compared with the group of 1-4 years old , the Z-score distribution curves of weight, length/height and BMI shifted to the right for all included ASD patients against the reference line of Z-score normal distribution, showing a trend of obesity. The distribution curve of BMI Z-score in ASD children aged 5-8 years had a low peak, and the proportion of body symmetry decreased. It extended to over ±2 SD, and deviated to obese and wasted growth status. Conclusion:The deviation of physical growth status of children with ASD included both obesity and emaciation. School-age children with ASD had a higher incidence of physical growth deviation, a lower ratio of fit-shape figure, and deviated to obesity and emaciation.