The prevalence of metabolic syndrome (MetS) in the young population continues to rise. This study aimed to determine whether adipokines are significant markers in defining MetS in a pediatric population and to assess the effect of a hypocaloric diet and physical activity on serum concentrations of adiponectin, leptin, and high-sensitivity C-reactive protein (hs-CRP). A prospective study was conducted over a period of 1 year, between January and December 2015, on 66 cases of obesity in children diagnosed at the Louis Turcanu Emergency Hospital for Children in Timisoara, Romania. The patients diagnosed with MetS were put on diet and physical exercise for 3 months. MetS was present in 63.6 % of obese children. There was a significant and positive correlation between MetS and both leptin and hs-CRP and a significant, negative correlation between MetS and adiponectin. After diet and physical activity, 3 patients no longer met the criteria for MetS. Leptin, adiponectin and hs-CRP concentrations statistically improved after a three-month diet and physical activity program. In conclusion, hs-CRP, leptin and adiponectin can be used as predictors of cardiovascular risk in the pediatric population. Diet and physical activity have an impact on metabolic status.