This study explored current physiotherapy practice trends for management of children who are overweight or obese. The professional needs of physiotherapists working with this population were also assessed, including the perceived need for physiotherapy clinical guidelines for prevention and management of children with obesity. A cross-sectional survey design was used, with questionnaires purposefully distributed through 13 key physiotherapy services throughout Australia. Snowball sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Half (n≤33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, one-quarter had prior training specific to working with this population. Most used multi-disciplinary models (n≤16, 76%) and provided under 5h of obesity-related services each week (n≤29, 88%). Half (n≤16, 49%) used body mass index as an outcome measure but more (n≤25, 76%) used bodyweight. Only 14 (42%) assessed motor skills. The majority of respondents (n≤57, 89%) indicated a need for physiotherapy guidelines to best manage overweight and obese children. Professional development priorities included: 'Educating children and families', 'Assessment methods' and 'Exercise prescription' for overweight and obese children. This data provides workforce intelligence to guide future professional training and inform development of clinical guidelines for physiotherapists in prevention and management of children with obesity and related chronic disease.