OBJECTIVE: We analyzed the magnitude of the association between cardiovascular disease (CVD) risk factors and various measures of overweight among adolescents, to determine which indicator of overweight is most relevant for risk assessment. METHODS: 5,546 boys and girls aged 11-17 years participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were studied. Overweight was assumed when different anthropometric variables exceeded age- and sex-specific 90th percentiles. Blood pressure was measured and blood samples were analyzed for serum total cholesterol, lipoproteins, high-sensitivity C-reactive protein, and glycosylated hemoglobin (HbA1c). RESULTS: In both sexes, overweight was significantly associated with adverse levels of CVD risk factors, except HbA1c. These associations were most pronounced for overweight as defined by waist circumference (WC), waist-to-height ratio (WHtR), or BMI. Between 11% and 37% of the overweight children exceeded the defined cut-offs for individual CVD risk factors, with age- and puberty-adjusted significant odds ratios (95% confidence interval (CI)) in comparison to normal-weight age mates ranging from 1.7 (1.0-3.0) to 6.1 (4.5-8.2). CONCLUSIONS: The findings of this population-based survey suggest that, among adolescents, WC, WHtR, and BMI are easily applicable measures of overweight that appear to be relevant for CVD risk assessment.