The article discusses the alarming increase in childhood obesity and its significant impact on cardiovascular risk (CVR) and metabolic syndrome (MS). Early childhood overweight and obesity are associated with biochemical and inflammatory factors that affect vascular physiology, leading to endothelial dysfunction and increased arterial stiffness. These changes can occur before clinical manifestations of atherosclerosis. The impairment of endothelial function and the degree of insulin resistance in obese children are linked to premature atherogenicity and adult CVR factors. Adipose tissue factors, such as leptin and adiponectin, play crucial roles in mediating the increased risk of CVR. The article highlights the importance of assessing vascular function in children through noninvasive methods to detect early signs of endothelial dysfunction and arterial stiffness. It also emphasizes the need for primary and secondary prevention programs involving diet and exercise to improve vascular function and metabolic disorders in children with overweight or obesity. The development of these programs is essential to prevent the long-term health complications associated with childhood obesity.The article discusses the alarming increase in childhood obesity and its significant impact on cardiovascular risk (CVR) and metabolic syndrome (MS). Early childhood overweight and obesity are associated with biochemical and inflammatory factors that affect vascular physiology, leading to endothelial dysfunction and increased arterial stiffness. These changes can occur before clinical manifestations of atherosclerosis. The impairment of endothelial function and the degree of insulin resistance in obese children are linked to premature atherogenicity and adult CVR factors. Adipose tissue factors, such as leptin and adiponectin, play crucial roles in mediating the increased risk of CVR. The article highlights the importance of assessing vascular function in children through noninvasive methods to detect early signs of endothelial dysfunction and arterial stiffness. It also emphasizes the need for primary and secondary prevention programs involving diet and exercise to improve vascular function and metabolic disorders in children with overweight or obesity. The development of these programs is essential to prevent the long-term health complications associated with childhood obesity.