This study aimed to analyze the variations of N-terminal pro B-type natriuretic peptide, epicardial adipose tissue thickness, and carotid intima-media thickness in childhood obesity. The study participants consisted of 50 obese children in the study group and 20 nonobese children referred for evaluation of murmurs who proved to have an innocent murmur and were used as control subjects. All the subjects underwent transthoracic echocardiographic examination for determination of left ventricular systolic function and mass index, myocardial tissue rates, and myocardial performance index. Epicardial adipose tissue thickness and carotid intima-media thickness also were measured during echocardiography. Serum N-terminal pro B-type natriuretic peptide levels were measured at the time of evaluation. The left ventricle mass index was 40.21 ± 10.42 g/m² in the obese group and 34.44 ± 4.51 g/m² in the control group (p > 0.05). The serum N-terminal pro B-type natriuretic peptide level was 109.25 ± 48.53 pg/ml in the study group and 51.96 ± 22.36 pg/ml and in the control group (p = 0.001). The epicardial adipose tissue thickness was 5.57 ± 1.45 mm in the study group and 2.98 ± 0.41 mm in the control group (p = 0.001), and the respective carotid intima-media thicknesses were 0.079 ± 0.019 cm and 0.049 ± 0.012 cm (p = 0.001). The left ventricular systolic and diastolic functions showed no statistically significant correlations with N-terminal pro B-type natriuretic peptide levels, carotid intima-media thickness, or epicardial adipose tissue thickness values. The results show that measurement of serum N-terminal pro B-type natriuretic peptide level, carotid intima-media thickness, and epicardial adipose tissue thickness in asymptomatic obese children is not needed.