To document the characteristics of the striae in obese children and adolescents, 89 obese patients (56 males, 33 females) with a mean age of 9.6 +/- 3.0 years and range of 3 to 19 years who came to our pediatric nutrition clinic were studied. Obesity was defined as a weight-for-length index (WLI) above 1.2 (range 1.39 to 2.68). Striae were identified in 36 (40.4%) of the 89 patients. Generally, striae were present over both sides of the body symmetrically. Striae most prominently located on the thighs (73%), the arms (42%), and the abdomen (30%), less frequently on the back, buttocks, and over the knees. In about 40% of the patients, multiple sites were involved. There is no sex difference between striae and non-striae groups. Compared with the non-striae group, striae occurred in older age patients (11.5 vs 8.2 years, p = 0.0001), and more often in those with a longer duration of obesity (7.1 vs 5.0 years, p = 0.0002). A high prevalence of striae was found in more obese patients (WLI > 1.8). We conclude that striae might be associated with obesity, and the interpretation of striae as a cutaneous manifestation of obese children and adolescents should be considered.