Background: Obesity, as a risk factor for many noncommunicable diseases, is a common public health problem in developed and developing countries. Among Iranian children and adolescents, the prevalence of being overweight has increased by almost 50% in the past two decades. Aims: To visualize the geographic differences in general and abdominal obesity risks and related determinants among Iranian children and adolescents. Methods: Participants consisted of 14 880 students, aged 7–19 years, living in urban and rural areas of the Islamic Republic of Iran. Spatial patterns of obesity and its association with related risk factors were identified using Bayesian spatial modeling. Results: The highest spatial risks of general obesity (odds ratio 1.21–1.66 for males and 1.81–2.02 for females) and abdominal obesity (odds ratio 1.20–1.82 for males and 1.25–1.78 for females) were observed in the north, northwest and southwest of the country. Risk of obesity was significantly higher in areas with a higher rate of urban residence, active current smokers and prolonged screen time. Conclusion: Identification of high-risk regions for obesity and spatially related risk factors can be used as informative tools for decision-making and planning in health systems at national and subnational levels.