This study aimed to assess the prevalence of picky eating among preschool children and to evaluate the association between eating behavior and growth, physical activity, development, and health status. A structured questionnaire was used to conduct a cross-sectional descriptive study of 300 primary caregivers of children aged 2-4 years in Taiwan. Data collected included: demographics, food preferences, eating behavior, body weight, and height, development, physical activity, and records of medical illness. Data from children defined as picky or non-picky eaters based on parental' questionnaire responses were analyzed and compared using standard statistical tests. The mean age of the children was 2.95 years; 162 (54%) were picky eaters. Compared with non-picky eaters, -score of weight-for-age, height-for-age, and body mass index (BMI)-for-age in picky eaters was 0.91, 0.73, and 0.44 SD lower, respectively. There were significant differences of rates in the weight-for-age, height-for-age, and BMI-for-age percentiles <15, between picky and non-picky eaters (  = 0.04, 0.023, and 0.005, respectively). Fear of unfamiliar places, poor physical activity, constipation, and high frequency (>2 times in the past 3 months) of medical illness were significantly higher in picky eaters (  = 0.01, 0.001, 0.044, and <0.001, respectively). The prevalence of picky eaters in preschool children was high, resulting in significant detrimental impacts on growth, nutritional status, development, physical activity, and health status.