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Objectives: To compare the prevalence of obesity in children with sleep-disordered breathing (SDB) who undergo adenotonsillectomy to that in the general pediatric population., Design: Cross-sectional controlled study., Methods: A body-mass-index (BMI-for-age) percentile was determined for children with SDB and for matched controls from a general pediatric clinic. Children who were obese (>85th %) were analyzed. Groups were compared using a t test or chi(2) analysis. Risk factors were estimated with logistic regression., Results: The study population included 299 children, of whom 170 (56.9%) had SDB. Compared with controls, more children with SDB were obese (46% vs 33%, P = 0.029) or underweight (8% vs 3%, P = 0.110), and fewer children with SDB were healthy weight (46% vs 64%, P = 0.002). Among African American children, those who were obese were more likely to have SDB (OR, 2.22, P < 0.01)., Conclusions: Children with SDB who undergo adenotonsillectomy are more likely to be obese than children seen in a general pediatric clinic. African American children who are obese are more likely to have SDB.