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This study aimed to explore the impact of environmental factors such as latitude, altitude, family socioeconomic status (SES), and level of urbanization on overweight and obesity (ow/ob) in children and adolescents. The participants comprised 26,120 children and adolescents aged 10–18 from 16 provinces in China. Differences in the prevalence of ow/ob under different environmental conditions were evaluated by the chi-square test. The influence of various environmental factors on ow/ob was obtained by logistic regression analysis. We found that (1) the prevalence of ow/ob fell between from 19.2% to 11.9% at 10 years old and from 13.8% to 6% at 18 years old; (2) latitude, family SES, income, and urbanization level are positively correlated with the prevalence of ow/ob; and (3) altitude has a negative correlation with the prevalence of ow/ob. The prevalence of ow/ob decreased with age in children and adolescents aged 10–18, and the risk of ow/ob showed significant differences in latitude, altitude, family SES level, gross domestic product (GDP), and level of urbanization.