SUMMARYThe objective was to construct growth charts for Saudi children under 5 years of age with Down's syndrome (DS). A prospective cross‐sectional survey of anthropometrics standards (weight, height, head circumference and weight for height) of Saudi children with DS, excluding those with associated pathology, and a group of normal children seen at King Khalid University Hospital, Riyadh, Saudi Arabia, during 2001 were studied. Both groups were compared to a reference population of American children documented by the National Center for Health Statistics/Center for Disease Control. A total of 785 children with DS and 989 normal children were studied. Growth charts for the different parameters in both sexes at each age were used to estimate seven centiles. The growth pattern for children with DS differed significantly from normal children and was characterised by short stature at most ages. Data indicated a high proportion of underweight children with DS in the first two years of life, but a clear tendency to be overweight by the age of 3 years; 54.5% of children with DS had a head circumference below −2 SD for age and sex. The results of this study accord with others indicating a genetic effect of DS on growth, and support the use of growth charts in conjunction with charts for normal children for assessing growth in DS in Saudi Arabia.