Abstract Aim This study was conducted to assess development and cognitive functions in relation to growth in Saudi pre‐school children with feeding problems (FP s) without underlying medical disorders. Methods Three hundred fifteen pre‐school children with FP s (221 with normal growth (FP ‐N ), 62 with failure to thrive (FTT ) (FP‐FTT ), 32 with overweight (FP‐OW )) and 100 healthy children (Ref group) underwent in‐depth assessment by anthropometric measurements, dietetic history, Behavioral Pediatrics Feeding Assessment Scale, D enver Developmental Screening test (DDST ) and S tanford B inet fifth edition intelligence scales (SB ‐5). Results The main FP s detected in S audi children were picky eating in 85.5% of FP ‐N group, infantile anorexia and poor eating in more than 90% of FP‐FTT group and overeating in 53% of FP‐OW group. FP s were not due to evident psychosocial factors but were mostly related to unhealthy feeding behaviours. FP ‐N children were still having normal growth parameters, but they had significantly lower growth parameters than healthy children. Failed screening with DDST was only more significantly recorded in FP‐FTT children than in Ref children (P = 0.04). The overall IQ value by SB ‐5 was significantly lower in FP‐FTT group compared with FP ‐N group (P = 0.01), in FP‐FTT group compared with Ref group (P < 0.001) as well as in FP‐OW group compared with Ref group (P < 0.001). Conclusions Persistent FP s resulted in significant negative impact not only on growth status but also on developmental milestones and cognitive functions of pre‐school children. Healthy feeding habits are mandatory to prevent serious consequences of FP s on growth and development of S audi pre‐school children.