This study adopted a case study design with mixed methods to examine Chinese kindergarten children's body size perceptions. Forty-two Chinese kindergarten children between ages five and six were interviewed through child-friendly language. Results showed majority of children could describe the image provided to them and explain the differences among different body sizes. Indicated by this group of children, different body sizes were predominately associated with different amounts of food, types of meat, and vegetable consumptions. In particular, a strong connection between the consumption of meat and body size differences was revealed. An important sociocultural influence on children's learning about health concepts was evident. In particular, mothers were indicated as the most influential social factor. Gender differences in body size choices were few but not statistically significant. Findings from this study revealed a need to provide young children with positive learning experiences associated with body image and health. This could be achieved through appropriate modeling and communications of a healthy lifestyle from parents and/or by participating in classroom activities associated with food and exercises integrated in the curricula.