A cross-sectional study was conducted to assess the prevalence of overweight, obesity, and elevated systolic blood pressure (SBP) in ethnically diverse adolescents (1064 males; 974 females; 13-17 years) in a rural community. Prevalence of overweight was 20.4% in females and 17.5% in males. In contrast, the prevalence of obesity was 29.4% in males and 14.5% in females. African American males had the highest prevalence of obesity (33.3%) compared with non-Hispanic whites (26.3%). Prevalence of elevated SBP was higher than pre-elevated SBP in males regardless of race/ethnicity, but not in females. Obese females had 4-fold and 9-fold greater odds of developing pre-elevated SBP and elevated SBP, respectively, than their normal weight cohorts. Prevalence of obesity is almost twice that of overweight in males in our rural population suggesting that adolescent males from disadvantaged, rural populations are potentially at a greater risk for metabolic disorders than those in major metropolitan areas.