Background: While both high birth weight and childhood overweight/obesity have been associated with a heightened risk of high blood pressure (BP) during childhood, the association between weight status change from birth to childhood and the risk of high BP has not been fully explored. This study aimed to investigate how changes in weight status from birth to childhood influence the development of high BP in childhood. Methods: The data for this study were obtained from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study, which included 1237 children aged 6 to 11. Children with a birth weight under 2500 g or a body mass index (BMI) below the fifth percentile for their age and sex during childhood were excluded. Based on birth weight (high birth weight [>4000 g] vs. healthy [≤4000 g]) and childhood weight status (overweight [including obesity] vs. healthy weight), participants were categorized into four groups: consistently healthy weight, weight decrease, weight increase, and consistently excess weight. Results: Compared to children who maintained a healthy weight from birth to childhood, higher odds of childhood high BP was observed among those with consistently excess weight (odds ratio [OR] = 2.73, 95% confidence interval [CI] = 1.46–5.12) and those with a weight increase (OR = 2.77, 95% CI = 1.91–4.02). In contrast, children with a weight decrease did not exhibit significantly higher odds of childhood high BP (OR = 0.94, 95% CI = 0.36–2.45). Conclusion: Children who become overweight in childhood or who consistently had excess weight from birth were at higher risk of childhood high BP. However, the risk of high BP in childhood may be mitigated or eliminated in individuals with high birth weight who achieve a healthy weight by childhood.