Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed. Chi-square analyses (2?x?2) were used to compare risk levels of WHTR (>0.50) and BMI (greater than 85th percentile) to systolic blood pressure (SBP) (>90th percentile) as well as total cholesterol (TC) (>200?mg.dL[superscript -1]) for the entire cohort and specified age groups. Results: Significant relationships were detected between SBP and WHTR and BMI, respectively, for the entire cohort as well as the 2 oldest subsamples. A significant association was also noted for both WHTR and BMI to TC for the entire sample and the eldest age group. Conclusions: A significant association was observed between indicators of cardiovascular health risk and both WHTR and BMI in the entire NHANES cohort of boys and girls as well as in the older age groups. The younger groups of participants did not display a notable link between these cardiovascular indicators and WHTR or BMI.