AIM: To elucidate links of blood serum uric acid level (SUAL) with cardiometabolic risk factors (CMR) in adolescent boys with arterial hypertension (AH). MATERIAL AND METHODS: We examined 261 adolescent boys (mean age 15.8+/-1.3 years) with primary AH. Examination included 24-hour blood pressure (BP) monitoring, and measurement of office BP, BMI Z-score, levels of serum glucose, uric acid, total cholesterol (TC), high density lipoprotein cholesterol (HDL) and triglycerides (TG). Low density lipoprotein cholesterol (LDL) was calculated using Friedwald equation. RESULTS: SUAL was significantly and independently of patient age related to BMI Z-score (=0.0000001) and TG level (=0.01). There were no correlation between SUAL and glucose level. According to logistic regression analysis highest tertile of SUAL was regardless of age significantly associated with excess body mass and obesity (odds ratio [OR] 3.5 [95% confidence interval [CI] 1.9-6.7; =0.0001]), and dyslipidemia (OR 3.05, 95%CI 1.3-6.9; =0,007]). Significant relationship was also found between elevated SUAL and clasterization of 2-3 CMR (OR 3.2, CI 1.3-7.7; =0.01]). CONCLUSION: Hyperuricemia in adolescent boys with AH is a marker of high cardiometabolic risk. This justifies screening for high SUA levels among boys with elevated BP with subsequent estimation of individual risk and timely initiation of preventive measures.