AimTo evaluate the indications, population characteristics and latency between short stature diagnosis to treatment with recombinant growth hormone (GH) therapy in a large cohort of children in Israel.MethodsWe performed a retrospective medical chart review of all children treated with GH for conditions associated with short stature in three central districts in Israel from 1 January 2010 to 31 December 2021. Data extracted from the medical files included demographics, time to diagnosis, treatment indications and GH therapy duration.ResultsThe study group comprised 5148 children aged 1 day to 17 years. A total of 64.1% were diagnosed with idiopathic short stature (ISS), 31.1% with GH deficiency (GHD) and 2.5% with small-for-gestational age (SGA). Males were treated more than females (58.9% vs. 41.1%). The mean age at first documentation of short stature was 6.9 +/- 3.5 years. GH therapy was initiated at a mean age of 9.8 +/- 3.3 years. A total of 51.2% were of high socio-economic status (SES); 78.2% were non-ultraorthodox Jews, 13%, ultraorthodox Jews, and 8.8% were Arabs.ConclusionMeticulous growth follow-up from early childhood for all children, specifically females, those of low SES, and minorities is important to provide appropriate referral, treatment and final adult height outcomes.