Background: Overweight / obesity is a major risk factor for non-communicable disease (NCD). Neck circumference (NC), a measure of upper body fat, can be used to predict obesity and its related disorders. Objectives: To find the association of NC and obesity with blood pressure (BP) in children aged 6-12 years. Method: A cross-sectional observational study was carried out over a period of 5 months; 800 children aged 6 to 12 years were included in the study and their body mass index (BMI), NC and BP were recorded with standard techniques. Children with malnutrition, neck abnormalities and metabolic disorders were excluded from the study. All variables were analysed using SPSS version 21. Receiver Operating Characteristic (ROC) curve was used to determine the best cut-off value of NC to predict obesity and hypertension. Results: Of 800 children, 463 (57.9%) were boys and 337 (42.1%) were girls; 46 (9.9%) boys and 16 (4.7%) girls were obese and 55 (11.9%) boys and 46 (13.6%) girls were hypertensive. NC had a significant correlation with BMI in both boys and girls (p <0.001). Median NC in boys was 28 (26-29) and 27 (26-29) in girls. The best cut-off value of NC by ROC curve to identify obese boys was 24.5-25.5cm with a sensitivity of 93.5% and a specificity of 9.6%. The best cut-off value of NC by ROC curve to identify obese girls was 24.5-25.5cm with a sensitivity of 93.8% and a specificity 12.8%. The best cut-off value of NC by ROC curve to identify hypertensive boys, was 28.5-29.5cm with a sensitivity of 87.3% and a specificity 20.3%. The best cut-off value of NC by ROC curve to identify hypertensive girls, was 25.5-26.5cm with a sensitivity of 82.6% and a specificity 22.3%. Conclusions: In our study there was a strong association of elevation in BP with high NC and overweight/obesity. The NC measurement was a simple, non-invasive test to detect obesity and hypertension in children © 2022 Elsevier B.V., All rights reserved.