Abstract BACKGROUND: Abdominal obesity is a predictor for many cardio-metabolic disorders in different age groups. The use of available information on factors associated with abdominal obesity has been proposed as an effective way of identifying at-risk individuals. To assess the effectiveness of a risk scoring system for abdominal obesity in a large and representative population of youths. METHODS: Waist-to-height ratio (WHtR) is an effective surrogate measure of abdominal obesity in children. This analysis was performed to find out the normal cut off value for WHtR by calculating the risk score. To develop a risk score to identify high-risk individuals for abdominal obesity, we analyzed data from a national survey, entitled CASPIAN Study, that was conducted on a nationally - representative sample of Iranian students aged 6-18 years. The risk equation was determined by a multiple logistic regression analysis, and Receiver Operator Characteristics (ROC) analysis was used to determine the cut-off value for the risk equation. RESULTS: The independent risk factors associated with abdominal obesity were living in rural area, attending public school, positive family history of diabetes and obesity in first and second degree relatives, lower mother’s education level, number of household members; whereas physical activity decreased this risk. The area under curve (AUC) for the ROC was 63% (95% CI: 0.612, 0.643).A CASPIAN study population value>=39 had optimum sensitivity (64%) and specificity (54%) for determining abdominal obesity score. CONCLUSION: This method can be helpful in screening and prevention of abdominal obesity by identifying those at-risk individuals in a timely manner. Keywords: Risk Score; abdominal obesity; prediction; children.