To differentiate the screening potential of waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body mass index (BMI) for the presence of elevated blood pressure (BP) in Chinese children. A total of 2799 boys and 2672 girls aged 6-10 years participated in this cross-sectional study. Weight, height, WC and hip circumference were measured, and WHR, WHtR and BMI were calculated. Elevated BP was defined as systolic BP and/or diastolic BP ≥ 95th percentile for age and gender. Both linear and logistic regression showed that WC had the strongest associations with BP values or risk of elevated BP, and the association was more substantial in boys than in girls. The area under receiver operating curves for the presence of elevated BP were highest for WC (0.770, 95% confidence interval: 0.754-0.785) in boys. In girls, WC, BMI and WHtR showed similar discriminatory capacity for elevated BP and were slightly higher than that of WHR. The optimal cutoff values of WC were 71.1th percentile for boys and 83.5th percentile for girls. WC was a simple and sensitive measure in the identification of elevated BP regardless of sex in children in Guangzhou, China.