Abstract Background Central obesity is associated with an increased risk of cardiovascular disease (CVD), but community-wide screening in adolescents is inadequate. Therefore, we examined six simple anthropometric measures for their utility in screening adolescents for seven silent CVD risk factors. Methods A representative community-based sample of 3038 German adolescents (1639 males) aged 12–18 years participated in the study. The association between hypertension, dyslipoproteinemia, fasting hyperglycemia, body mass index, waist circumference (WC), hip circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and skinfold thickness was assessed. Results The prevalence of central obesity, defined as elevated WC and/or elevated WHtR, was 13.7% and 13.4% in male and female adolescents, respectively. Among these 412 adolescents, risk factor clustering was 3–4 times more frequent than in the 2626 adolescents without central obesity. Central obesity was the only anthropometric variable that significantly predicted increased risk for all seven non-anthropometric CVD risk factors: hypertension (OR 2.5), elevated triglycerides (OR 4.9), LDL-C (OR 2.0), non-HDL-C (OR 2.1), triglyceride/HDL-C ratio ≥3.5 (OR 7.2), low HDL-C (OR 1.6), fasting glucose (OR 1.3), and risk factor clustering (OR 3.8). General adiposity only detected hyperglycemia (OR 1.8) and hypertension (OR 4.9), whereas skinfold thickness in or above the 90th percentile predicted risk factor clustering (OR 1.9), elevated triglycerides (OR 2.3), and triglyceride/HDL-C (OR 3.9). WHR indicated hypertriglycridemia (OR 2.3). Conclusions Cardiovascular risk factors in adolescents are easily identified by central adiposity.