Abstract Background: The growth hormone (GH)–insulin-like growth factor-1 (IGF-1) axis is a master endocrine regulator for growth and development in children. GH and IGF-1 play significant roles in regular biological processes in childhood and puberty, including cell proliferation and differentiation, organ growth and development, skeletal growth, and metabo-lism. Although IGF-1 is mainly secreted by the liver, it may be produced in several other tissues as well. Serum IGF-1 levels increase as the child grows, reach a peak value at puberty, and decrease with aging. Aim of Study: The current study aimed to evaluate serum insulin-like growth factor-1 (IGF-1) levels in Egyptian healthy preschool children. Patients and Methods: This cross sectional study was con-ducted on 100 children admitted from Outpatient clinic, Chil-dren's Hospital, Ain Shams University in a period of 6 months starting from November 2023 till April 2024; they were 44 fe-males (44.0%) and 56 males (56.0%) with age ranged from 2-6 years and with mean ± SD of 3.68±1.20 years. Results: Anthropometric measurements revealed that all participants had a weight SDS within the normal range (–2 to 2), while 95% had a height SDS within the normal range. Only one child had a height SDS below -2, and four children had a height SDS above 2. Regarding BMI SDS, 97% of the chil-dren were within the normal range, and 3% had a BMI SDS above 2. The median IGF-1 level in the study population was 131.5ng/mL (IQR: 90.25-181.15), with a range of 38-300ng/ mL. A significant positive correlation was found between IGF-1 levels and age (r=0.206, p=0.039). No significant correlations were found between IGF-1 levels and other parameters such as weight, height, and BMI SDS. When analyzing the relationship between IGF-1 levels and various parameters using non-para-metric tests, no statistically significant differences were found based on age group, gender, height SDS, or BMI SDS. Conclusion: Our study suggested that IGF-1 levels increase with age in this population. In our study IGF-1, levels are not significantly influenced by gender, height, or BMI.