Background/aim: Nesfatin-1, an anorexigenic molecule, seems to play a role in appetite regulation and energy homeostasis. e goal of this study was to evaluate the relation of nesfatin-1 with anthropometric and metabolic (ghrelin, leptin) parameters in children with idiopathic chronic malnutrition. Materials and methods: The study included 37 underweight and 38 healthy children who were similar regarding age, sex, and pubertal status. Anthropometric and biochemical (nesfatin-1, ghrelin, and leptin levels) variables were assessed. Results: A total of 37 underweight subjects (mean age 10.5 &pm; 2.6 years) and 38 heathy subjects (mean age 10.3 ± 2.3 years) were recruited. Underweight children had signi cantly higher nesfatin-1 (2.76 &pm; 0.4 vs. 1.56 &pm; 0.7, P < 0.001) and lower leptin levels (2.21 &pm; 2.0 vs. 5.21 &pm; 2.4, P < 0.001) than those of the control subjects. Nesfatin-1 levels were signi cantly associated with only leptin levels, a er adjusting for age and BMI (r = ?0.371, P = 0.001). Conclusion: The present study is the rst to evaluate nesfatin-1 levels in relation with anthropometric and metabolic parameters in children with chronic malnutrition, who were subsequently found to have signi cantly higher nesfatin-1 levels. Our study underlines that nesfatin-1 may play a role in the development of malnutrition by inhibiting food intake in children.