Background Pathological and beneficial outcomes have been documented in children and adolescents exposed to disasters, but the patterns of the outcomes are not known. This study was conducted to identify patterns of post‐traumatic stress symptoms and post‐traumatic growth and examine the predictors for the patterns among children and adolescents following an earthquake. Method Self‐reported measures (post‐traumatic stress symptoms, post‐traumatic growth, disaster exposure, and social support) were assessed among a total of 618 participants (age 12.26 ± 2.75) at 8 months post disaster. Latent profile analysis was utilized to identify the patterns of post‐traumatic stress symptoms and post‐traumatic growth, and multinomial logistic regressions were conducted to examine the predictors for the patterns. Results Three patterns were identified. Most of the participants fell into the Thriving pattern and smaller proportions fell into either the Resilient or Stressed and Growing pattern. Loss and injury, subjective fear, and social support could predict the membership in patterns of post‐traumatic stress symptoms and post‐traumatic growth. Conclusions Practitioners are suggested to identify the pattern of post‐traumatic stress symptoms and post‐traumatic growth for different children and adolescents, and provide the service targeting their needs.