Purpose: This study was done to identify perceived body image, intentional caloric restriction and physical manifestations of unbalanced nutrition according to the Body Mass Index (BMI) in elementary school students. Methods: The research design was a cross-sectional descriptive study. Data collection was done by using a structured questionnaire that consisted of 34 items. Participants were 151 students in 5th and 6th grades of elementary schools in Gangwon province. Frequency and percentage, one-way ANOVA, and 2-test with SPSS WIN 12.0 were used to analyze the data. Results: In elementary school students, over-weight/obesity and normal weight groups reported that they would be satisfied with a thinner body image compared to the present image. The score for intentional caloric restriction was significantly higher in the over-weight/obesity group than in the under-weight group. In physical manifestations of unbalanced nutrition, students in the under-weight group frequently were pale and had dry skin, whereas the over-weight/obesity group reported frequent upper respiratory symptoms. Conclusion: The results suggest that elementary school students need to develop the perception of an adequate body image and to avoid inadequate caloric intake if promotion of the child`s growth and development is to be without physical manifestations of unbalanced nutrition.