Childhood obesity is now recognized as one of the most serious health issues worldwide, along with metabolic abnormalities, which are frequent among obese children increasing the risk of chronic diseases in adulthood. Visceral adiposity index (VAI) and triglyceride glucose (TyG) index have recently been identified for detecting type 2 diabetes and cardiometabolic risk in children. This study aimed to estimate VAI and TyG and investigate their possible associations with insulin resistance and cardiometabolic alterations among obese Egyptian children. One hundred pre-pubertal children were enrolled in the study, including 70 obese and 30 normal-weight controls. VA and TyG indices were determined based on biochemical analysis. Obese children showed significantly higher VAI and TyG index values compared to control group. In obese children, VAI exhibited significant positive correlations with cardiac risk ratios I and II, as well as TyG index. The TyG index demonstrated significant positive correlations with total cholesterol, cardiac risk ratios I and II, along with significant negative correlation with high density lipoproteins (HDL). In conclusion, the VA and TyG indices can be suggested as effective predictors of insulin resistance and cardiometabolic risk in obese children. Furthermore, greater VA and TyG indices in obese children suggest a tendency to insulin resistance, type 2 diabetes, and cardiovascular injuries, which should be considered to prevent the occurrence and progression of these complications throughout life.