Background: To evaluate the effectiveness of individualized-dose polyethylene glycol recombinant human growth hormone (PEG-rhGH) for short stature. Methods: This real-world study enrolled children with short stature in 19 hospitals throughout China. They were treated with PEG-rhGH for 6 months. The starting dosage ranged from 0.10 to 0.20 mg/kg/week. The primary outcome was the change in height standard deviation score (Delta Ht SDS). Results: Five hundred and ten patients were included and grouped based on dosage as A (0.10-0.14 mg/kg/week), B (0.15-0.16 mg/kg/week), C (0.17-0.19 mg/kg/week), and D (0.20 mg/kg/week). The mean 6-month Delta Ht SDS for the total cohort was 0.49 +/- 0.27, and the means differed among the four dose groups (P = 0.002). The Delta Ht SDS was lower in group A than in groups B (LSM difference [95%CI], -0.09 [-0.17, -0.01]), C (LSM difference [95%CI], -0.10 [-0.18, -0.02]), and D (LSM difference [95%CI], -0.13 [-0.21, -0.05]) after adjusting baseline covariates. There were no significant differences among groups B, C, and D. When the baseline IGF-1 was <-2 SDS or > 0 SDS, the Delta Ht SDS was not different among the four groups (P=0.931 and P=0.400). In children with baseline IGF-1 SDS of-2 similar to 0 SDS, a higher dosage was associated with a better treatment effect (P= 0.003), and the Delta Ht SDS was lower in older children than in younger ones (P<0.001). Conclusions: PEG-rhGH could effectively increase height in prepubertal short children. When the baseline IGF-1 was <-2 SDS, 0.10 mg/kg/week could be a starting dose. In other IGF-1 statuses, 0.15-0.20 mg/kg/week might be preferred.