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Title: Prevalence of Elevated Arterial Pressure and Associated Risk Factors in 10 to 15 Year Old Students from the Municipality of Cajazeiras-PB, Brazil. Background: Overweight and obesity are rising on developing countries among all age groups. Children and adolescents are, therefore, exposed to higher risk of developing hypertension. Early identification can help avoiding or lessening complications through the life span. In order to plan adequate prevention programs, cities need to identify the prevalence of such condition. We aimed to identify the prevalence of Elevated Arterial Pressure (EAP) and associated factors in students from the municipality of Cajazeiras-PB, Brazil, a region in the Northeast of Brazil. Methods and Finding: At this cross-sectional study, in 2011, we measured arterial pressure of 690 children and adolescents from both genders, age 10 to 15-year-old, following the parameters recommended by the Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents. We measured sociodemographic, behavioral, clinical, and hemodynamic variables. In the statistical analysis, we used the software SPSS 18.0. The significance level was established as p≤.05. In our total sample 55.4% were female, and the mean age was 12.8 + 1.4 years. Prevalence of EAP was 3.5% and it was associated with large waist circumference, overweight, experience of hunger, and tobacco exposure. The prevalence of systolic and diastolic hypertension were 2.5% and 1.7%, respectively. In a logistic regression we observed that subjects exposed to tobacco were 2.65 times more likely to have EAP (95% CI: 1.021 - 6.861), when compared to their not exposed peers. Those that ever experienced hunger had an odds ratio of 3.73 to present EAP (95% CI: 1.134 - 12.256). Conclusions: The prevalence of EAP was within the average observed in previous studies at this age group. Routinely monitoring of arterial pressure is important to early identification of EAP in this population. Stake holders in the state of Paraiba, Brazil, should include this monitoring in the protocol of pediatric visits in public health facilities.