Objectives To investigate the association of blood pressure elevation with body mass index (BMI) and total cholesterol levels in children who screened positive for proteinuria, glucosuria, and/or hamaturia. Study design From 1992 to 2000, a mass urine screening program was conducted annually for nearly 3 000 000 students aged 6 to 18 years. Of 99 350 students with positive results on urine tests, further examination found 17 548 students (17.7%) had blood pressure elevation. A case-control analysis was performed with randomly selected subjects with normal blood pressure who were frequency matched by sex and age. Results The adjusted odds ratio for blood pressure elevation in obese students was 3.45 (95% CI, 3.20-3.72), compared with students of normal weight. The odds ratio for blood pressure elevation increased to 6.15 (95% CI, 4.12-9.18) for students with a total cholesterol level ≥250 mg/dL and obesity, compared with students with a total cholesterol level <200 mg/dL and normal weight. Conclusion This study found a high prevalence of elevated blood pressure in children with abnormal urinalysis results, with a strong association with BMI and total choleterol level.