Type 2 diabetes mellitus, previously considered an adult disease but currently being observed in children and adolescents all over the world due to parallel increase in obesity. It is crucial to check obese children and adolescents for prediabetes to avoid long-term diabetes problems. This study aimed to identify a risk factors for prediabetes in obese children and adolescents. Method:  A prospective case-control study was conducted on children aged 6-18 years at Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basra (South Iraq). Results: A total of 155 children participated in the study; 60% were males. Prediabetes was present in 44.5% (n=69) participants. The proportion of prediabetes by FBS was 40%, OGTT was 16.8%, and HbA1c was 37.4%. A family history of T2DM, diastolic blood pressure, physical activity, and triglycerides were found to be significantly associated with prediabetes (P-value <0.05). In a multivariate logistic analysis of risk factors; a family history of T2DM (OR = 0.205; CI =0.094-0.446; p-value < 0.0001), physical activity (OR = 3.059; CI =1.532-6.109; p-value=0.002), high triglycerides (OR, 2.888; CI: 1.241-6.722; p-value=0.014), and hypertension (OR, 0.447; CI: 0.230-0.868; p-value=0.017) were positive or negative significantly associated with the occurrence of prediabetes.