Introduction: In addition to childhood obesity status, the family history of cardiovascular disorders might be used as a tool for screening youth to identify those at the highest risk of developing metabolic impairments later in life. Thus, the aim of the present study was to examine associations between parental history of cardiovascular disease risk factors and childhood cardiometabolic risk, and to examine the role of cardiorespiratory fitness (CRF) and obesity in mediating the relationship between parental history and global cardiometabolic risk. Methods: A cross-sectional study was developed with 2,213 Brazilian youth. The cardiometabolic risk factor (CMRF) score, CRF, and waist circumference (WC) were evaluated. Parental family history of cardiovascular risk factors was obtained through a self-reported questionnaire. Results: Family history of hypertension, high cholesterol, diabetes, and obesity were associated with a higher CMRF score. Also, hypertensive father and high maternal cholesterol, and obesity in both parents increased the prevalence rates of these conditions in the offspring. WC was a mediator in some of these associations, while CRF was a protector for a lower metabolic risk. Conclusion: Evaluating family history, along with WC and CRF is essential for determining pediatric cardiometabolic risk.