Objectives This study aimed to provide evidence for the use of Korean medicine in underweight patients by analyzing the medical records of underweight children and adolescents. Methods Children and adolescents who visited Korean pediatrics at Kyung Hee University Hospital from June 1, 2019 to May 31, 2022, who had an age-specific weight percentile which was less than 5 and diagnosed with E639.005 or R628.001 were selected for the study. A retrospective chart review was conducted by examining the medical records of subjects who received Korean medical treatment. The treatment effect was analyzed in all subjects and subgroups by comparing changes in height, weight, and body mass index (BMI) percentiles before and after Korean medicine treatment. Results A total of 55 underweight subjects were included in the study. General characteristics such as distribution by sex, age, number of visits, and weight percentile, and clinical characteristics such as diagnosis, past history, family history, drug history, current or past symptoms, and symptom differentiation were collected. The composition of herbal medicines and the contents of other Korean medical treatments were analyzed. In the case of treatment effect, the weight and BMI percentile of all subjects increased significantly. Conclusions This study was conducted to suggest Korean medicine as a method of proper weight management in children and adolescents. In the future, follow-up studies with a large number of subjects and controlled variables, such as the period of taking herbal medicine, are needed.