BackgroundLittle is known about the cardiorespiratory fitness (CRF)‐cardiometabolic risk relationship in Latin American pediatric populations across different age/sex groups, especially when considering the potential effects of adiposity on the association. We evaluated cross‐sectional associations between VO2max and cardiometabolic risk variables (CMRV), and verified whether the associations were independent of adiposity markers in school‐aged children and adolescents from Cali, Colombia.MethodsThe sample consisted of 1206 children aged 5–17 years. CMRV were fasting glucose, HDL and LDL cholesterol, triglycerides, systolic, and diastolic pressure. Logistic regressions were conducted for associations of age/sex‐specific tertiles of VO2max with age/sex‐specific highest tertiles of CMRV (except HDL‐C, lowest tertile) and a CMR cluster (> 2 CMRV in extreme tertiles), adjusting for socioeconomic stratum, and adiposity markers (BMI, body fat percentage, and waist circumference).ResultsOverweight/obesity ranged from 15% to 18% with no difference by sex. In children aged 5–11 years, high VO2max (highest tertile vs. lowest) was inversely associated with the CMR cluster [Odds ratio (95% confidence interval): 0.18 (0.06–0.47), p < 0.05] independently of adjustment for any adiposity marker in boys but not in girls. In the age group of 12–17 years, there were initially significant VO2max‐ CMR cluster and VO2max‐ CMRV associations but attenuated by adiposity adjustment. In girls, high VO2max was inversely associated with high systolic blood pressure regardless of adjustment for adiposity markers.ConclusionVO2max is inversely associated with cardiometabolic risk, but adiposity influences the association. The adiposity‐independent association among younger boys requires further research. Interventions to tackle cardiometabolic risk in childhood may primarily focus on reducing excess adiposity, and secondarily on improvement of CRF.