Somatic delay in growth and puberty is commonly referred to as “late growth” and refers to boys who have not seen a testicular volume greater than 4 ml by age 14, and girls who have not seen breast development by age 13 or menstruation by age 16. Somatic delay in growth and puberty is mostly seen before puberty, but can also be seen in early childhood. Clinically, it is more common in boys, more than 5 times as often as in girls. Children with somatic growth and puberty delays have normal weight and height at birth and grow more slowly than normal children of the same age from 3-6 months to 2 years of age. After 3 years of age, the growth rate is basically normal, but it may slow down again before puberty. As a result, prepubertal height is more backward than normal children of the same age. Children are usually behind in bone age, and by the time they reach the usual age of puberty, no breast development is seen in girls and no laryngeal nodes or voice change is seen in boys, which often causes concern for parents. In order to exclude other diseases that cause short stature, a pediatric endocrinologist should be consulted promptly. First of all, hypogonadism should be excluded: children with somatic delay in growth and puberty usually develop their sexual characteristics before the age of 16 for girls and 18 for boys. If pubertal development is still not seen by the age of 19, hypogonadism, rather than growth and puberty delay, is most likely the cause, and a sex hormone-related stimulation test should be done promptly to clarify the diagnosis. Second, to exclude growth hormone deficiency, a growth hormone drug provocation test should be done. In children with somatic delay in growth and puberty, the results of growth hormone stimulation test are often normal; however, sometimes growth hormone can be low, which is common in children with prepubertal development, similar to partial growth hormone deficiency. The growth hormone returns to normal by the time the child reaches puberty. Third, hypothyroidism should be excluded. Blood thyroid function should be checked to confirm or exclude the diagnosis. Fourth, congenital ovarian hypoplasia, or Turner syndrome, should be excluded. In girls with clinical manifestations such as short stature and pubertal dysplasia, blood chromosome tests should be performed to clarify the diagnosis. Growth and pubertal somatic delay are usually after 16 years of age in boys and after 14 years of age in girls. Once pubertal development starts, the growth rate accelerates and eventually, although most adult heights are in the normal range, they are still 5-7 cm lower than their genetic target height. There is often a family history of somatic delay in growth and puberty. Some fathers report that growth acceleration did not begin until after high school or college, or after joining the military. Some mothers also have a history of late growth, such as age of menarche after 15-16 years of age. Some parents have short stature and late pubertal growth, and their children are affected by a combination of familial short stature and delayed pubertal growth. These children appear even shorter in childhood.