OBJECTIVE:To identify possibly independent associations of perinatal, sociodemographic and lifestyle factors with childhood total and visceral body fat. DESIGN:A representative sample of 2655 schoolchildren (9-13 years) participated in the Healthy Growth Study, a cross-sectional epidemiological study. SETTING:Seventy-seven primary schools in four large regions in Greece. SUBJECTS:A sample of 1228 children having full data on total and visceral fat mass levels, as well as on anthropometric, dietary, physical activity, physical examination, socio-economic and perinatal indices, was examined. RESULTS:Maternal (OR=3·03 and 1·77) and paternal obesity (OR=1·62 and 1·78), maternal smoking during pregnancy (OR=1·72 and 1·93) and rapid infant weight gain (OR=1·42 and 1·96) were significantly and positively associated with children's increased total and visceral fat mass levels, respectively. Children's television watching for >2 h/d (OR=1·40) and maternal pre-pregnancy obesity (OR=2·46) were associated with children's increased total and visceral fat mass level, respectively. Furthermore, increased children's physical activity (OR=0·66 and 0·47) were significantly and negatively associated with children's total and visceral fat mass levels, respectively. Lastly, both father's age >46 years (OR=0·57) and higher maternal educational level (OR=0·45) were associated with children's increased total visceral fat mass level. CONCLUSIONS:Parental sociodemographic characteristics, perinatal indices and pre-adolescent lifestyle behaviours were associated with children's abnormal levels of total and visceral fat mass. Any future programme for childhood prevention either from the perinatal age or at late childhood should take these indices into consideration.