Purpose: The waist-to-height ratio (WHtR), an index for central adiposity adjusted for height, is a newly introduced tool for screening people at higher metabolic risk. This study was performed to investigate the relationships between WHtR and cardiometabolic risk factors in Korean adolescents. Methods: We analyzed data for 1816 adolescents (956 boys and 860 girls) aged 10-18 years from the Korean National Health and Nutrition Examination Surveys conducted between 2009 and 2010. Results: The WHtR was significantly related with waist circumference (R2=0.8767, P0.0001), systolic blood pressure (R2=0.1276, P0.0001), glucose (R2=0.0837, P=0.0012), high density lipoprotein (HDL)-cholesterol (R2=0.0796, P0.0001), and triglycerides (R2=0.0616, P0.0001). When compared to boys with WHtR 0.5, the odds ratios (95% CI) for hypertension (3.68(1.92-7.06)), hyperglycemia (2.60(1.32-5.10)), low HDL-cholesterol (2.01(1.17-3.48)) and hypertriglyceridemia (4.15(2.51-6.85)) were significantly increased in boys with WHtR ≥0.5. In girls with WHtR ≥0.5, the odds ratios for low HDL-cholesterol (3.73(2.04-6.83)) and hypertriglyceridemia (3.52(1.83-6.77)) were significantly increased when compared to those with WHtR 0.5. The odds ratios for having 3 or more risk factors were higher in adolescents with WHtR ≥0.5 (OR(95% CI) = 45.4(12.2-169.7) and 17.2(5.6-52.9) in boys and girls, respectively) when compared to those with WHtR 0.5. Conclusion: WHtR is closely related with cardiometabolic risk factors in Korean adolescents.