Objective This study aimed to investigate the correlation between the Subjective Global Nutritional Assessment Tool (SGNA) and anthropometric measurements, as well as to evaluate its clinical efficacy in assessing the nutritional status of hospitalized children with neurological impairments. Methods A retrospective analysis of 1466 pediatric patients with neurological impairments admitted to the Department of Children’s Rehabilitation were conducted from January 2019 to October 2019. Nutritional status was evaluated using the SGNA, and its effectiveness was corroborated against the World Health Organization's recommended anthropometric Z-score method. Results The prevalence of moderate and severe malnutrition, as well as overall malnutrition, as determined by SGNA, were 15.14%, 3.27%, and 18.41%, respectively. In comparison, the rates identified using weight-for-height Z-score (WHZ), weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), and composite Z-score were 9.69%, 12.48%, 10.10%, and 21.56%, respectively. When using WAZ as the benchmark, the sensitivity, specificity, and Youden’s index for SGNA were 86.62%, 88.90%, and 0.76, respectively. With the composite Z-score as the reference, these values were 57.28%, 92.27%, and 0.50, respectively. A moderate level of agreement was observed between SGNA and both WHZ and the comprehensive Z-score (Kappa values of 0.53 and 0.523, both P<0.001). The SGNA assessment demonstrated significant correlations with both the WAZ and WHZ, with correlation coefficients of -0.52 and -0.45, respectively. Conclusion The SGNA emerges as a comprehensive nutritional assessment instrument that surpasses anthropometry in scope and can be reliably utilized for nutritional assessment in children with neurological impairments.