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Pediatric obesity has reached epidemic proportions in the USA and Europe. The use of BMI report cards is one approach to addressing the epidemic that is gaining popularity across the USA and in the UK.Recent findings suggest that parents of overweight children underestimate child weight status and the majority of pediatric overweight and obesity goes undiagnosed in primary care settings in the USA. Although there is no argument against the efficacy of tracking a child's BMI and informing parents of their child's weight status, there is considerable controversy surrounding whether schools should be involved in BMI screening. Research on the efficacy of BMI report cards suggests that parental awareness of weight status is not improved by BMI report cards. Findings are inconclusive on whether BMI report cards lead to changes in weight-related health behaviors, and there is no evidence to suggest that report cards ultimately impact weight status. Additionally, research indicates that BMI report cards may increase dieting, a risk factor for both increased weight and eating disorders in adolescents.Research does not suggest that BMI report cards will be effective in reducing rates of pediatric overweight and obesity. Instead, recent findings show that the potential for harm may outweigh possible benefits. States and countries that mandate the use of BMI report cards should make evaluation of these policies a priority.