Idiopathic intracranial hypertension is an important cause of headaches in the pediatric population and can lead to permanent blindness if not diagnosed in a timely manner. The aim of this study was to characterize the incidence of papilledema and obesity in children with idiopathic intracranial hypertension. We retrospectively analyzed 27 patients followed at The University of Texas Houston Pediatric Neurology Clinic. Papilledema was absent in 13 (48%) patients. The majority of our patients were nonobese (70%). Our results are contrary to the current medical practice of associating papilledema and obesity with idiopathic intracranial hypertension in childhood and highlight the importance of revised diagnostic criteria in this population needed to detect and manage this condition.