Purpose: The objectives were to use National Health and Nutrition Examination Survey (NHANES) data to: 1) estimate the prevalence of metabolic syndrome (MetS) risk factors (elevated blood pressure, triglycerides, blood glucose, and low HDL cholesterol); 2) estimate the prevalence of MetS using three common definitions; and 3) compare the odds of MetS risk factors/ MetS when using different measures of abdominal obesity (sagittal abdominal diameter (SAD) versus waist circumference (WC)) among United States adolescents. Methods: Analyses were performed on data collected from adolescents aged 12-19 years (N = 1,214) participating in the 2011-2016 NHANES. Prevalence of MetS risk factors and MetS were estimated. Unadjusted and adjusted binomial/multinomial logistic regressions were performed to test associations between WC and SAD z-scores and MetS risk factors/MetS. Results: Males were more likely to have MetS risk factors. Depending on sex and the definition applied, the prevalence of MetS ranged from 2% to 11% and was lowest among females. Adjusted logistic regressions showed that one z-score increase in SAD and WC resulted in similar increased odds of MetS risk factors/MetS, but associations between abdominal obesity and MetS may vary by definition applied and race/ethnicity. Conclusions: Metabolic dysfunction and MetS are prevalent among U.S. adolescents, and it is important to consider how MetS components and MetS are measured in population inference.