Objectives To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations’ health and potential to experience metabolic disorders. Methods Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO 2 peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO 2 peak (inverted) Z-score, but divided by six. Results The clustered risk score, considering the all ages sample, was better in the Brazilian boys (−0.20 [−0.41;0.01] and −0.18 [−0.37;0.01], including or not VO 2 peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO 2 peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO 2 peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO 2 peak (only boys). Conclusions The clustered cardiometabolic risk score (including or not VO 2 peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.