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Ketogenic Therapy (KT) is a treatment for intractable epilepsy shown to be effective in reducing seizures. This diet consists of high fat, adequate protein, and low carbohydrate. Although KT has been used for decades, the potential adverse effects are unknown. To evaluate the potential for growth abnormalities, a retrospective analysis of patients since 1995 and on KT for at least 1 year was performed. Data was collected in an Access database and a macro was used to determine the BMI and z scores. Statistical analysis was done with significance reported by p values <0.05. Ht z score became progressively worse over time. The most significant difference from 0–6 mo was found at >60 mo on diet. The only significant change from baseline for wt z score was seen at >60 mo on diet (μ=−0.9±1.8, −1.6±1.4, p=0.036). There were no significant differences compared to baseline for BMI z score. The question of decreased linear growth being a direct adverse effect of KT remains unknown. Some evidence has shown that epileptic patients have lower stature compared to a healthy, normal population. Additional controlled, prospective studies should be designed to further investigate the effect of KT on growth.