Background Lectin‐like oxidized low‐density lipoprotein (ox‐LDL) receptor‐1 is a scavenger receptor for oxidized low‐density lipoprotein. In adults, higher soluble lectin‐like ox‐LDL receptor‐1 (sLOX‐1) levels are associated with cardiovascular disease, type 2 diabetes, and obesity, but a similar link in pediatric overweight/obesity remains uncertain. Methods and Results Analyses were based on the cross‐sectional HOLBAEK Study, including 4‐ to 19‐year‐olds from an obesity clinic group with body mass index >90th percentile (n=1815) and from a population‐based group (n=2039). Fasting plasma levels of sLOX‐1 and inflammatory markers were quantified, cardiometabolic risk profiles were assessed, and linear and logistic regression analyses were performed. Pubertal/postpubertal children and adolescents from the obesity clinic group exhibited higher sLOX‐1 levels compared with the population ( P <0.001). sLOX‐1 positively associated with proinflammatory cytokines, matrix metalloproteinases, body mass index SD score, waist SD score, body fat %, plasma alanine aminotransferase, serum high‐sensitivity C‐reactive protein, plasma low‐density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure SD score, and inversely associated with plasma high‐density lipoprotein cholesterol (all P <0.05). sLOX‐1 positively associated with high alanine aminotransferase (odds ratio [OR], 1.16, P =4.1 E‐04), insulin resistance (OR, 1.16, P =8.6 E‐04), dyslipidemia (OR, 1.25, P =1.8 E‐07), and hypertension (OR, 1.12, P =0.02). Conclusions sLOX‐1 levels were elevated during and after puberty in children and adolescents with overweight/obesity compared with population‐based peers and associated with inflammatory markers and worsened cardiometabolic risk profiles. sLOX‐1 may serve as an early marker of cardiometabolic risk and inflammation in pediatric overweight/obesity. Registration The HOLBAEK Study, formerly known as The Danish Childhood Obesity Biobank, ClinicalTrials.gov identifier number NCT00928473, https://clinicaltrials.gov/ct2/show/NCT00928473 (registered June 2009).