BackgroundChildhood obesity is a global public health concern with major consequences. In Saudi Arabia, the percentage of children who are overweight or obese have significantly increased in the past 2 decades, raising concerns about the physical and psychosocial consequences of this burden. This study aimed at investigating the different risk factors contributing to childhood obesity in Saudi Arabia.Methods A case-control study was conducted among 492 school children (246 overweight/obese cases and 246 normal control aged 5-9 years old). Using valid and reliable instruments, parental and children characteristics, behavioural practices, screen use, and other activities were assessed as risk factors for childhood obesity using logistic regression analysis. Results An unemployed father (OR=11.90; 95%CI: 7.47-18.93), an overweight/obese father (OR=2.04; 95%CI: 1.40-2.96), an incorrect parental perception of child’s weight status (OR=2.54; 95%CI: 1.75-3.68), Caesarean delivery (OR=2.52; 95%CI: 1.56-4.09), daily time in active play for less than 30 minutes (OR=2.18; 95%CI: 1.44-3.28), , frequent snacking (OR=1.74; 95%CI: 1.05-2.93), and screen time use for more than 2 hours per day outside of school (OR=1.62; 95%CI: 1.12-2.34) were all independent risk factors for being overweight or obese among the selected cases. ConclusionEfforts to prevent childhood overweight and obesity in this population should focus primarily on the early identification and addressing of risk factors, such as parental characteristics and awareness of the magnitude of the burden of obesity, behavioural practices such as frequent snacking, screen time use, and physical activity.