BACKGROUND It is not known whether fat deposition in obese children and adolescents occurs in the body's central or peripheral regions. METHODS A representative sample of children was drawn from the schools of Zaragoza, Spain. The population selected comprised 1728 children ranging in ages from 6 to 14.9 years. Of the original sample, 368 children (21.29%) were excluded because of chronic diseases or refusal to participate. The waist-to-hip circumference ratio and the triceps-to-subscapular skin-fold thickness ratio were calculated and served as indexes of body fat distribution. The children were divided into tertiles according to standard deviation score of body mass index. RESULTS Both in boys and in girls, waist-to-hip circumference ratio was higher in tertile 3 than in the other two tertiles, and triceps-to-subscapular skinfold thickness ratio was lower in tertile 3 than in the other two tertiles. Waist-to-hip circumference ratio was higher and triceps-to-subscapular skinfold thickness ratio was lower in obese than in nonobese children and adolescents of both sexes. CONCLUSIONS Increased adiposity may be accompanied by an increase of fat depot in the abdominal region. In obese children and adolescents, fat deposition seems to occur in the body's central regions.