Low anthropometric status based on height and weight is commonly used as a sign of malnutrition. In developing countries low anthropometry is prevalent, due to poor dietary intake, infectious disease, or both. In the U.S., where the prevalence is low, the underlying reasons as to why children exhibit low anthropometry are not clear. This study documents the prevalence of low anthropometry and examines the characteristics of children with low anthropometric status. This is a descriptive study of two case series (inpatients and outpatients) of children with low anthropometry from Grady Memorial Hospital and its five satellite clinics, an urban hospital complex in Atlanta, GA. The subjects are predominantly low-income African American infants and children between the ages of 3 months and 10 years. Low anthropometry is defined as a <−2.00 Z-score below NCHS-CDC reference median in Ht-for-Age or Wt-for-Ht. The prevalence of low Ht-for-Age and low Wt-for-Ht was 3.7% and 2.1% among inpatients and 4.1% and 1.3% among outpatients, respectively. Approximately 85% of inpatients and 55% of outpatients were either low birth weight babies and/or had a chronic illness. Findings imply that although the prevalence of low anthropometry in these low-income children is near the expected baseline prevalence of the current growth reference (2.3%), the majority of the children had a significant medical background that could explain their low anthropometry.