Obesity has emerged as one of the most important epidemics in the Western hemisphere, and as its prevalence continues to increase in children, the associated risk for cardiovascular and metabolic complications follows parallel increases in prevalence, and reflects activation of underlying inflammatory pathways. The obstructive sleep apnea syndrome (OSAS) is a frequent condition in children associated with intermittent upper airway obstruction during sleep, its prevalence is markedly increased in the presence of obesity, and is associated with activation of similar inflammatory mechanisms as those activated by obesity, suggesting that the 2 disorders may reciprocally contribute to their adverse consequences. C-reactive protein (CRP) is a prototypic marker of inflammation that has repeatedly shown promise as a potentially reliable biomarker of cardiovascular morbidity. In addition, under certain circumstances CRP may enhance inflammation, oxidative stress, and pro-coagulant activity and thus promote atherogenesis. In this paper, we will critically review the available evidence linking OSAS to systemic inflammation in children using CRP levels as the reporter biomarker.