The obesity and overweight epidemic, together with increasing cardiovascular disease, represent a major public health problem worldwide, and their occurrence in childhood and adolescence has increased in recent decades. The objective of this study was to assess the association between waist-to-height ratio (WHR) and the incidence of hypertension in adolescents.We performed a cross-sectional study of adolescents aged 10-17 years of both sexes attending municipal schools in inland Rio Grande do Sul, Brazil. Using a secondary database, weight and height measurements, blood pressure, and waist circumference (WC) were analyzed and body mass index (BMI) and WHR were calculated. Blood pressure was classified according to the Brazilian hypertension guidelines, BMI according to the curves of the World Health Organization, and WC according to Taylor et al. The cutoff used for WHR was 0.50 for both sexes.Of the 1030 adolescents studied, 29.6% (305) presented overweight/obesity and 30.4% (313) had hypertension; 24% (247) had high WC and 18.3% (189) presented high WHR. Participants with WHR ≥0.50 were 2.4 times more likely to have hypertension than those with WHR <0.50 (OR 2.39; 95% CI 1.73-3.32; p<0.001).A positive association was found between WHR and the presence of hypertension in adolescents.