Abstract Background: There is a clear association between metabolic syndrome (MetS) in children with high risk of type 2 diabetes and cardiovascular disease later in life. Objective: The aim of the current work was to detect prevalence of MetS and risk factors of pediatric metabolic syndrome (PMS) in obese children. Subject and Methods: This cross-sectional study was performed at the Departments of Pediatrics and Clinical Pathology, Zagazig University Hospitals. It included 136 primary school-age children having obesity. High-density lipoprotein-cholesterol (HDL-C), fasting plasma glucose (FPG), triacylglycerols (TGs), total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) were assayed. Modified adult treatment panel (ATP-III) classification and cook et al definition were used for assessment of MetS in children involved in the study. Results: A high prevalence of MetS was found in the obese children population (35.3% according to cook et al. definition of MetS and 26.5% according to modified ATP classification). Waist circumference was the major contributor to a metabolic syndrome where each 1 cm increase in circumference increased the risk factor of metabolic syndrome by 1.59 (P<0.0001), followed by systolic blood pressure (SBP) where each 1 mmHg increase in blood pressure led to increased risk of metabolic syndrome by 1.06 (P=0.015). Finally, total cholesterol was the third contributor where each one mg/dl increase in total cholesterol level led to increased risk of metabolic syndrome by 1.02 (P=0.035). Conclusion: It could be concluded that childhood obesity is strongly linked to the occurrence of metabolic syndrom