Introduction and Aim: Prehypertension and obesity are the important cardio metabolic risk factors for developing metabolic syndrome. Neck circumference (NC) is an effective marker and screening tool for obesity. It gives a quick assessment of the upper body fat distribution. Early detection of obesity and prehypertension can increase the longevity of the individual. Hence, we aimed at evaluating the association of NC with prehypertension and obesity in young adults.   Materials and Methods: A cross sectional study where 150 Paramedical students were screened for prehypertension and fifty students were identified as pre-hypertensives (n=50). Routine anthropometric measurements were taken. NC was measured. The correlation of NC with body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) was calculated. The prevalence and percentage distribution of obesity using NC in prehypertensive was calculated. The association of NC with obesity and prehypertension was demonstrated.   Results: The prevalence of obesity in prehypertensive students was 58%. The distribution of obesity using NC was 61% in males and 55% in females. Further, the association of NC with BMI (r=0.53,p=<0.0001), SBP(r=0.52,p=<0.0001) and DBP (r=0.44, p=<0.0001) was calculated using Pearson’s correlation and was statistically significant.   Conclusion: There was an increased prevalence of obesity among pre-hypertensives with a male predisposition. The study also establishes a statistically significant and strong correlation of NC with BMI, SBP and DBP. NC can be used as an effective screening tool to assess obesity and prehypertension.