The prevalence of overweight is rising in the pediatric population. The aims of this study were to determine prevalence and diagnostic characteristics of overweight patients referred for endocrine evaluation. BMI was calculated and diagnosis codes were assigned for patients seen for endocrine evaluation. Odds ratio calculation and logistic regression were used to evaluate overweight patients. Rising odds of overweight was seen as age increased. Referring diagnoses associated with a significant (p <0.05) proportion of overweight patients included excessive growth, other pubertal disorders, and menstrual disorders. Endocrinologist diagnosis of overweight had a significantly higher proportion of overweight patients. Concordance between referring and endocrinologist diagnosis decreased as BMI category rose. A low percentage of records of overweight patients documented discussion of weight management. Certain referring diagnoses have higher proportion of overweight individuals representing clinical findings associated with being overweight. Opportunities are missed to diagnose overweight individuals as well as to begin weight management counseling.