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Background: Most of the Non-communicable Diseases (NCDs) including obesity and hypertension originate in early life, and manifest in adulthood leading to increased morbidity and mortality. Its identification among children has remained neglected area in India. Aim and Objectives: To estimate the prevalence of overweight, obesity and hypertension among school children and various risk factors among them to propose sustainable intervention. Material and Methods: A cross-sectional study was conducted among 544 school children between the ages of 10 to 14 years in Madurai. A semi-structured questionnaire was used to evaluate the social-demographic characteristics, diet history, and other behavioral risk factors. Anthropometric measurements were recorded using standard equipment and methodology. Results: The mean age of the respondents was 11.81 ± 0.041 years and 343 were male and 201 were female students. A total of 49 (9%) children were overweight and 5 (0.91%) were obese. Stage 1 hypertension was observed among 74 (13.60%) children and 15 (2.75%) children were having stage 2 hypertension. Children residing in urban area (p=0.001, OR=3.065), belonging to upper socioeconomic class (p=0.001) having higher systolic (p=0.054), diastolic blood pressure (p=0.010), and watching TV>2 hours (p=0.000) were significantly associated with overweight/obesity. Higher Body Mass Index (BMI) (p=0.001, OR= 1.113), consumption of snack and junk foods (p=0. 0.011, OR =1.255) and watching TV more than 2 hours (p=0.003, OR =1.870) were significant predictors for hypertension. Conclusion: The high prevalence of hypertension and its association with overweight/obesity and associated risk factors warrants immediate attention. Regular screening, care of children for Non-communicable Diseases (NCDs) and early identification of its risk factors followed by health education to make them adopt healthy lifestyle is the need of the hour.