Abstract: The global prevalence of obesity among children and adolescents is rising rapidly, and the long-term comorbidities of obesity pose serious threats to the population health and life expectancy. Interventions for childhood and adolescent obesity mainly include lifestyle and psycho-behavioral approaches. Pharmacological treatment and metabolic bariatric surgery are subject to strict clinical indications and, hence, have limited clinical application. In recent years, the concept of intragastric volume occupancy has emerged as a promising approach to the clinical management of childhood and adolescent obesity, for it has demonstrated notable weight-loss efficacy, broad applicability across different populations, a favorable safety profile, and sustained long-term effectiveness. Herein, we systematically evaluated the advantages and limitations of existing intervention strategies for childhood and adolescent obesity. We discussed the mechanisms of action, clinical application progress, and evaluation of weight loss effects of intragastric volume occupancy intervention methods. Further multicenter, large-sample studies are warranted to systematically elucidate the regulatory mechanisms of intragastric occupancy technology on the gut microbiota of children and adolescents, and to establish an evidence-based foundation for its translation into clinical practice for obesity intervention, accordingly.