Objective To analyze physical development data of preschool children aged 3-6 years in Urumqi, Xinjiang, assess their nutritional status, and provide a reference for improving early childhood growth and development in the city. Methods Health examination records of 15 904 children aged 3-6 years from 14 kindergartens across 7 districts in Urumqi between 2018 and 2024 were selected. Height and weight were measured using standard methods. Physical development and nutritional status were evaluated according to the National Health Commission's Growth Standards for Children Under 7 Years (2022 edition). Data were analyzed using IBM SPSS 26.0 with chi-square tests and chi-square tests for trend. Results Height, weight, and body mass index among children of different sexes and ages in Urumqi showed an upward trend over the years (P<0.05). From 2018 to 2024, the overall detection rate of stunting was 3.31% (526/15 904), underweight 2.00% (318/15 904), thinness 2.63% (418/15 904), overweight 16.74% (2 663/15 904), and obesity 8.78% (1 396/15 904). Boys had higher detection rates of malnutrition (9.12%) and overnutrition (26.48%) than girls (6.57% and 24.42%, respectively; both P<0.05). The detection rate of malnutrition showed a fluctuating downward trend over the years (P<0.001), whereas detection rates of overweight and obesity showed fluctuating upward trends (P<0.001). Conclusions Malnutrition among 3-6-year-old children in Urumqi has improved over time, whereas overweight and obesity rates have shown an upward trend. Weight management for children should be reinforced, with special attention to the monitoring and care of boys' growth and development.