Objectives: This study's purpose was to compare physical growth (PG) patterns of children and adolescents living at high elevations with those of other geographic regions, relate body adiposity indicators, and develop percentile reference tables for assessing physical growth and body adiposity. Methods: The sample included 1536 children and adolescents ages 5.0 to 17.9 years from Puno (Peru) located between 3821 and 4349 m above sea level. Weight, height, arm and waist circumferences (WC), and three skinfolds measurements were recorded. Body mass index (BMI) and waist-height Index (WHI) were calculated. Results: PG patterns for children living at a high altitude reflected similar values for weight, height, and arm circumference (AC) to those of their counterparts living in Puno (Peru) and La Paz (Bolivia). When compared with children living at moderate altitudes in Peru, they showed slightly lower PG values. BMI explained between 41% and 64% of the variance in sum of the skinfolds, while WC explained between 47% and 66%. HWI was not a strong predictor of variation in sum of skinfolds. Percentiles were generated for WC and the sum of skinfolds. Conclusion: Weight, height, and, arm and waist circumference patterns for children and adolescents living at high altitudes were similar to those of La Paz (Bolivia). WC and the sum of the skinfolds were better indicators for analyzing abdominal obesity compared to BMI and WHI. The percentiles proposed may be a useful tool for identifying high risk of developing overweight disorders in pediatric populations living at high altitudes.