Abstract: Objective To explore the serum levels of vitamin A and vitamin D in children with idiopathic short stature (ISS), and to investigate their correlations with growth and development, bone mineral density changes, and to assess their diagnostic efficacy. Methods A total of 146 children diagnosed with ISS at Yancheng Maternal and Child Health Hospital from May 2022 to December 2024 were enrolled as the ISS group, while 73 healthy children who underwent physical examinations during the same period were recruited as the control group. Serum levels of vitamin A and vitamin D, along with height, weight, and bone mineral density, were compared between the two groups. Pearson correlation analysis was used to assess the correlations between serum levels of vitamin A and vitamin D and height, weight, and bone mineral density. Using multivariate logistic regression, a diagnostic model for ISS based on serum levels of vitamin A combined with vitamin D was constructed. The receiver operator characteristic (ROC) curve model was employed to analyze the efficacy of vitamin A, vitamin D and their combination for the diagnosis of ISS. Results Serum levels of vitamin A and vitamin D in the ISS group were lower than those in the control group. Additionally, height, weight, and bone mineral density Z-scores in the ISS group were all lower than those in the control group (P ＜ 0.05). Pearson correlation analysis showed that serum vitamin A and vitamin D levels were positively correlated with height, weight and bone mineral density Z-scores, respectively (P ＜ 0.05). ROC curve analysis showed that the area under curve for diagnosing ISS using vitamin A, vitamin D and their combination were 0.711, 0.722, and 0.868, respectively. The sensitivities were 97.90%, 61.60% and 69.90%. The specificities were 49.30%, 75.30% and 86.30%. Conclusion Serum levels of vitamin A and vitamin D are significantly lower in children with ISS, and are positively correlated with their height, weight and bone mineral density Z-scores. Monitoring the changes in serum levels of vitamin A and vitamin D has certain efficacy for the diagnosis of ISS.