The aim of the current study was to investigate the relationship between the Oxygen Uptake Efficiency Slope (OUES) and traditional measures of cardiorespiratory function in an overweight/obese pediatric sample. Maximal treadmill exercise testing with indirect calorimetry was completed on 56 obese children aged 7–18 years. Maximal OUES, submaximal OUES, VO2peak, VEpeak, and ventilatory threshold (VT) were determined. In line with comparable research in healthy-weight samples, maximal and submaximal OUES were both correlated with VO2peak, VEpeak, and VT (r2= 0.44−0.91) in the obese pediatric sample. Correlations were also found with anthropometric variables, including height (cm), body surface area (m2), body mass (kg), and fat free mass (kg). In comparing our data to a published sample of healthy weight children, maximal and submaximal exercise OUES were both higher in our obese sample. However, when we adjusted for any of body mass (kg), BSA (m2), or FFM (kg) the obese children were found to be less efficient. The results of this study suggest the use of OUES to be an appropriate measure of efficiency of ventilation and cardiorespiratory function in obese children, while also showing that our sample of obese children were less efficient on a per kilogram basis when compared with their healthy weight peers.