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Objectives This study compared participation limitations in daily life activities among childhood cancer survivors across different Body Mass Index (BMI) categories.Design Prospective cross-sectional study.Setting The study data were collected from two separate oncology outpatient clinics.Participants 116 children with cancer aged 10.07±3.83 were included in the study. The mean follow-up time after cancer treatment turnover was 36.28±6.43 months.Primary outcome measures Participation levels were assessed using the Pediatric Outcomes Data Collection Instrument (PODCI) as the primary outcome of this study, and they were categorised by BMI.Results The mean z score was 0.64 ± 1.12, and the average BMI was 17.76±3.56. The PODCI global functioning score averaged 80.25±15.23. There were no significant associations between the global functioning score and age, chemotherapy, or surgery (p>0.05). However, significant relationships were found between the global functioning score and gender, BMI, and radiotherapy (p<0.05). Significant functional differences were observed in the upper extremity, basic mobility transfer, happiness and overall functioning (p<0.05). No significant differences were noted in sports and physical functioning or pain/comfort across different BMI categories (underweight, normal/healthy, overweight) (p>0.05).Conclusions Survivors experience participation restrictions in daily living activities after completing treatment. Systematic evaluation of feedback received from patients/parents regarding physical function, sports, transfer and participation highlights the importance of BMI in childhood cancer survivors. Addressing these factors is key to achieving better health-related quality of life in functionality and participatory outcomes for survivors.