Pediatric inflammatory bowel disease (PIBD) is a chronic immune-mediated inflammatory disorder of the gastrointestinal tract, with a steadily increasing global incidence. Growth retardation is one of the most common extraintestinal complications of PIBD, especially in children with Crohn's disease, severely affecting their quality of life and final adult height. The pathogenesis of this complication is complex, involving chronic intestinal inflammation, malnutrition, dysregulation of the endocrine axis, and adverse effects of glucocorticoid therapy. Current clinical management primarily focuses on controlling inflammation and optimizing nutrition, but some patients still experience persistent growth impairment. Recombinant human growth hormone (rhGH) directly promotes linear growth and its potential therapeutic value in PIBD has attracted increasing attention. This review summarizes the pathogenesis of PIBD-related growth retardation and outlines recent progress and clinical challenges in rhGH application in PIBD, aiming to provide a reference for the clinical management of PIBD-associated growth disorders.