Background: Growth assessment is one of the most reliable indicators of the overall health and nutritional status of children. School-aged children are particularly vulnerable to nutritional deficiencies that may adversely affect physical growth, cognitive development, academic performance, and future health. Regular nutritional assessment facilitates early identification of malnutrition and guides appropriate public health interventions.Objective: To evaluate growth patterns and nutritional status among school-aged children and identify factors associated with undernutrition and overweight.Methods: A retrospective cross-sectional observational study was conducted among 400 school-aged children (6–12 years) from government and private schools between January and December 2025. Anthropometric measurements including height, weight, and body mass index (BMI) were recorded. Nutritional status was assessed using age- and sex-specific growth standards. Demographic characteristics, dietary habits, physical activity, and socioeconomic factors were analyzed.Results: The mean age of participants was 9.3 ± 1.8 years. Boys constituted 52.0% of the study population. Normal nutritional status was observed in 63.0% of children, while 19.0% were underweight, 8.5% were stunted, 5.5% were overweight, and 4.0% were obese. Undernutrition was significantly associated with low socioeconomic status, inadequate dietary diversity, and recurrent infections, whereas overweight and obesity were associated with sedentary lifestyle, excessive screen time, and frequent consumption of energy-dense foods.Conclusion: Both undernutrition and overnutrition coexist among school-aged children, indicating a double burden of malnutrition. Routine growth monitoring, nutrition education, balanced diets, and promotion of physical activity are essential to improve child health outcomes.