Aim: To evaluate the total homocysteine (tHcy) level, a risk factor for atherosclerosis, atherothrombosis, and insulin resistance, for sex and pubertal state differences in obese children. Its relationship with metabolic and anthropometric parameters was also investigated. Materials and methods: The study involved obese children with a body mass index (BMI) above the 95th percentile who presented with the complaint of excessive weight gain, and healthy children with a BMI below the 85th percentile. Results: The study included 100 obese (mean age: 10.2 ± 2.7 years) and 71 healthy nonobese (mean age: 10.9 ± 2.6) children. A comparison of the data from the obese group and the control group revealed that the differences in BMI, BMI standard deviation score, tHcy, total cholesterol, triglyceride (TG), insulin, high-density lipoprotein (HDL), lowdensity lipoprotein (LDL), and homeostasis model assessment-insulin resistance (HOMA-IR) levels were statistically significant (P < 0.05). In the obese group, the tHcy level was statistically significantly correlated with age and BMI, TG, and HDL levels (P < 0.05), while it was not statistically significantly correlated with total cholesterol, LDL, fasting glucose, insulin, or HOMA-IR levels (P > 0.05). Conclusion: The results of this study showed that the tHcy level was higher in obese children than in healthy children. However, the tHcy level was not significantly correlated with insulin resistance in obese children. Obese children should be routinely screened for high tHcy levels due to the potential atherosclerosis risks, and patients with high tHcy levels should be treated. © TÜBITAK.