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Childhood obesity is rapidly increasing in prevalence worldwide, but healthcare capacity to address this problem seems limited.The purpose of this study was to describe the prevalence and rate of management of childhood overweight and obesity in Australian general practice.A cross-sectional study consisting of 3978 general practitioners (GPs), randomly selected using Medicare Australia claims, who recorded 42,515 encounters with children age 2–17 including 12,925 sub-sampled encounters with self or carer-reported height and weight collected.Prevalence of overweight and obesity, rate of management of overweight and obesity, content of encounters in overweight and nonoverweight children, content of encounters in those managed for overweight and obesity, and management to prevalence ratio.A total of 29.6% of sub-sampled children were classified as overweight (18.3%) or obese (11.4%). GPs managed overweight and obesity during 215 encounters, or once per 200 encounters with children age 2–17 and once per 58 encounters with overweight or obese children. The content of encounters in overweight and non-overweight children did not differ. Children who were managed for overweight or obesity presented with these conditions as reasons for the encounter significantly more often [66.5 (95% confidence interval (CI): 59.7–73.3) vs. 1.2 (95% CI: 1.0–1.3)] and were managed for more problems, particularly depression [4.2 (95% CI: 1.5–6.9) vs. 0.8 (95% CI: 0.7–0.9)], than average per 100 encounters. Consultations for overweight or obesity were significantly longer than average [16.7 (95% CI: 14.7–18.7) vs. 12.4 (95% CI: 12.2–12.5) minutes].Overweight and obesity are prevalent in children presenting to Australian general practice but GPs do not use most of the available opportunities to manage this problem.