A body mass index (BMI) report card is a tool to inform parents about their child's weight status. Body mass index notifications could curb childhood obesity by prompting parents to encourage their children to be more physically active and make better dietary choices, but they could also lower children's self-esteem and increase weight-related teasing. The purpose of this study was to comprehensively review existing evidence in order to determine the extent to which BMI report cards benefit and/or harm children and adolescents. The accuracy of BMI as an indicator of obesity, the positive and negative consequences of BMI notification programs, and suggestions for safer implementation of BMI report programs in schools are reviewed. Body mass index as a measure of weight-related disease risk in children has some limitations. Studies assessing the positive and negative consequences of BMI notification programs are limited in number and lack rigorous methodological procedures. Thus, the effects of sending BMI information to parents remain inconclusive. Yet, it cannot be ruled out that future carefully designed studies may find BMI notification effective. Until more research is available, practitioners are left to make their own conclusions about the implementation of school BMI report card programs. For schools and physical education teachers opting to report BMI information to parents, program safeguards are discussed.