Background and Objectives: Picky eating behaviours are common in young children and may adversely affect dietary intake. This study examined the adequacy of dietary patterns and nutrient intake in preschool-aged chil- dren in China and Hong Kong with picky eating behaviours and weight-for-height in the lowest quartile of the WHO Growth Standards. Methods and Study Design: Dietary intake was assessed using baseline 3-day food records from a multicenter, randomized trial in Chinese children (N=151) ages 2.5-5 years characterized as picky eaters by their parents and with weight-for-height ≤25th percentile of the WHO Growth Standards. Nutrient in- takes were calculated using validated dietary analysis software and compared with age-appropriate Chinese Rec- ommended Nutrient Intakes (RNIs). Dietary patterns were compared with Hong Kong Food Pyramid recommen- dations. Results: Median daily energy intake was 25% lower than the age-appropriate RNI, while median intakes of calcium, iron, zinc, and vitamins C and E ranged from 52%-73% of the RNI. Vitamin D intake was only 37% of the RNI. Total fat and sodium intakes exceeded recommendations by 10% and 56%, respectively, while >16% of daily energy was derived from foods in the sweets/beverages/snack and the fats/oils groups. Almost 75% of the children met the recommended daily servings of meat/meat substitutes and nearly half met the recommendation for daily servings of fruit. Fewer met the recommendations for daily servings of vegetables (14.7%), milk/milk products (6.3%), and grains and cereals (6.3%). Conclusions: Young children with picky eating behaviours and low weight-for-height had suboptimal dietary patterns and were at risk for significant dietary and nutrient insuffi- ciencies.