['Childhood obesity is associated with reduced quality of life, physical fitness, and a higher prevalence of lower extremity (LE) pain; however, it is unclear whether and how these factors are related.', 'For this study we asked if obese children with LE pain (LE+) had higher BMI-Z scores, lower physical function and psychosocial health, and lower physical fitness compared with obese children without LE pain (LE-). We determined the association of BMI-Z score with physical function, psychosocial health, or physical fitness in obese children.', "Medical charts of 183 obese children were reviewed. Recorded data included anthropometrics, demographics, reports of musculoskeletal pain, Pediatric Quality of Life (PedsQL)-Physical Function score, PedsQL-Psychosocial Health score, and physical fitness levels. Data from 175 individuals were included in the analysis, with 51 in the LE+\xa0group and 124 in the LE- group. Statistical analysis included Mann-Whitney U tests and Spearman's rank order correlations.", 'Between the LE+\xa0and LE- groups, BMI-Z and physical fitness scores were not different. The LE+\xa0group scored worse on the PedsQL-Physical Function scale (LE+: 72.4 [17.1], LE-: 79.5 [15.0]) and PedsQL-Psychosocial Health scale (LE+: 70.0 [16.1], LE-: 75.8 [16.3]). BMI-Z scores negatively correlated with PedsQL-Physical Function scores, PedsQL-Psychosocial Health scores, and physical fitness scores.'] Is lower extremity pain associated with reduced function and psychosocial health in obese children?