Chinese Americans are the largest and fastest growing Asian American subgroup, increasing about one-third during the 2000s. Despite the slender Asian stereotype, nearly one-third of 6-to-11 years old Chinese American children were found to be overweight (above the 85th percentile in BMI). Importantly, unique and severe health risks are associated with being overweight/obese in Chinese. Unfortunately, Chinese immigrant children have been neglected in the literature on obesity. This review aimed to identify factors at various levels of the ecological model that may place Chinese immigrant children at risk for being overweight/obese in the U.S. Key contextual factors at the micro-, meso-, exo-, macro- and chronosystem were identified guided by Bronfenbrenner’s ecological systems theory. The corresponding mediating and moderating processes among the factors were also reviewed and proposed. By presenting a conceptual framework and relevant research, this review can provide a basic framework for directing future interdisciplinary research in seeking solutions to childhood obesity within this understudied population.