BackgroundUpper body subcutaneous fat, estimated by neck circumference (NC), may present greater metabolic risk than visceral fat. The aim of this study was to determine cutoff values for NC in adolescents that identify overweight and obesity, the prevalence of elevated NC, and its association with associated factors.MethodsCross-sectional study with adolescents from public schools in São Paulo. Anthropometric variables, blood pressure and pubertal stage were collected. Cutoff values for NC were determined by Receiver Operating Characteristic curves. A binary logistic regression was used to determine relationships between NC and associated factors.ResultsAmong 1668 adolescents studied, 54.92% were female. The cutoff values of NC in girls and boys that identified overweight were 31.25 and 34.25 cm, and obesity, 32.65 and 37.95 cm, respectively, and the prevalence of adolescents with high NC was 32.63% in females and 37.63% among males. NC for overweight was observed that there was an association with sex, weight, body mass index, arm, waist and thigh circumferences, pubertal stages and body fat percent (BF%). NC for obesity was found association with gender, weight, arm and thigh circumferences, and BF% (p < 0.001).ConclusionIt was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering overweight and obesity, sex, weight, arm and thigh circumferences, BF%, besides being an easy and simple measure for use in clinical practice.