Objectives. To determine if the low iron state described in obese children is associated with the chronic inflammatory state seen in obesity. Study Design. Obese children age from 2 to 19 years seen at a weight management clinic were studied prospectively. Data were collected on age, gender, BMI, BMI z-score, serum iron, ferritin, transferrin saturation, free erythrocyte protoporphyrin, high sensitivity creactive protein (hs-crp), and hemoglobin concentration. Results. 107 subjects were studied. Hs-crp levels correlated positively with BMI (P < .001) and BMI z-score (P = .005) and negatively with serum iron (P = .002). 11.2% of subjects had low serum iron. Median serum iron was significantly lower for subjects with American Heart Association high risk hs-crp values (>3 mg/L) compared to those with low risk hs-crp (<1 mg/L), (65 mcg/dL versus 96 mcg/dL, P = .016). After adjusting for age, gender, and BMI z-score, serum iron was still negatively associated with hs-crp (P = .048). Conclusions. We conclude that the chronic inflammation of obesity results in the low iron state previously reported in obese children, similar to what is seen in other inflammatory diseases.