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Context: Small for gestational age infants have multifold increased risk of growth failure and adulthood disorders. Those who experience rapid catch up growth are at risk of developing metabolic syndrome, whereas those without catch up may end up with short stature. These children are also prone to an altered pubertal development. Need and Purpose: Scarcity of literature, lack of published guidelines on the follow-up and management plan of children born with small for gestational age. Evidence Acquisition: Literature search in PubMed was conducted with regard to epidemiology, growth and puberty, comorbidities, its pathogenesis and management in small for gestational age, with particular relevance for developing countries. An algorithm for follow-up of these children is outlined, based on available empiric data. Conclusions: Being born small for gestational age predisposes to many metabolic and pubertal disorders. Special emphasis is needed for early detection and management through early surveillance in growth clinics, and regular follow-up to prevent associated comorbidities. [ABSTRACT FROM AUTHOR]