Currently, the waist-to-height ratio (WHtR) has emerged as a practical and useful indicator for identifying cardiometabolic risk in child and adolescent population.To evaluate the association between the WHtR and cardiometabolic risk factors (CMRFs) in a cohort of children in Bucaramanga, Colombia.Analytical cross-sectional study. Child population between 6-10 years old from Bucaramanga (n = 1,282). Dependent variables: hypertension, pre-hypertension, overweight/obesity, impaired glucose, insulin resistance and dyslipidemia. Main independent variable: waist-toheight ratio. The association between dependent and independent variables was evaluated using binomial regression models.9.77% of the children presented a WHtR of risk (95% CI: 8.19% to 11.52%). After adjustment for age, sex, socioeconomic status and physical activity, the WHtR of risk was significantly associated with lower HDL levels and higher levels of triglycerides, insulin resistance, hypertension and pre-hypertension (PR = 2.46 95% CI :1.70 to 3.55, p = 0.000, PR = 2.24 95% CI: 1.50 to 3.35, p = 0.000, PR = 9.39 95% CI: 5.40 to 16.30, p = 0.000, PR = 8.03 95% CI: 2.01 to 32.07, p = 0.003 y PR = 2.67 95% CI: 1.60 to 4.47, p = 0.000, respectively).Children with WHtR of risk were more likely to develop high levels of blood pressure and triglycerides, insulin resistance and lower levels of HDL.