Children with short stature or puberty disorders should be assessed for underlying genetic, endocrine, or systemic causes. Referral to a pediatric endocrinologist is indicated for unexplained short stature, growth velocity <5cm/year, signification deviation from mid-parental height, or delayed/precocious puberty. Benign pubertal variants may be monitored, but progression or red flag symptoms (e.g., seizures, rapid development) warrant further investigation. Constitutional delay may be managed conservatively or with a short course of sex steroids. Treatment options for growth issues include growth hormone, oxandrolone or IGF-1, depending on the diagnosis. Accurate monitoring and timely referral are essential for optimal outcomes.