Non-alcoholic fatty liver disease (NAFLD) has serious health implications and upward trends of the disease, accompanied by the obesity epidemic worldwide.To screen for fatty liver in overweight and obese children and evaluate the factors associated with an increased likelihood of presenting a positive-screen result.In a cross-sectional study, 102 children were recruited at a secondary care medical unit. Serum alanine aminotransferase (ALT) levels were quantified and hepatic ultrasounds were performed; multiple logistic regression models were used to evaluate factors associated with the increased odds of presenting with NAFLD (fatty infiltration on ultrasound and ALT > 52 U/L for boys and > 44 U/L for girls).The overall prevalence of NAFLD was 10.8%. In multivariate analysis, a waist-to-hip ratio ≥ 1 was associated with increased odds of screening positive for NAFLD (odds ratio (OR) = 4.96, 95% CI 1.17-20.90).Our findings indicate that one out of ten children with overweight or obesity has data suggestive of NAFLD and is at risk of presenting its consequences on health.© 2021 Instituto Mexicano del Seguro Social.