Although obesity is a growing problem with Native American youth living on reservations, little research has been conducted examining the prevalence of obesity and correlations between age, body composition, dietary intake, and blood pressures (BP) for urban Native youth. The purpose of this study was to investigate the relationship of these variables in urban Native American youth. Height and weight were measured for 155 Native American youth, age 5–18 years, and the body mass index (BMI) was calculated and classified into percentile categories. Skinfold thicknesses at the biceps, triceps, suprailiac, and subscapular sites, arm and waist circumferences, and systolic (SBP) and diastolic (DBP) blood pressures were also measured. There was a high proportion of obesity (>95 percentile) for youth in all age groups. The prevalence was 38% for the 5–10-year-olds and 45% for the 11–18-year-olds youth. There were no significant correlations between SBP and DBP and dietary variables. Mean SBP and DBP increased with increasing BMI percentiles. Stepwise regression analyses showed that waist circumference, age, and BMI were strong predictors for SBP, while waist circumference and age were predictors for DBP in the total sample. The findings suggest that overweight/obesity is very prevalent among urban Native American youth and the increased adiposity is associated with increased SBP and DBP. Am. J. Hum. Biol. 15:78–90, 2003. © 2002 Wiley-Liss, Inc.