Pediatric obesity has emerged as one of the most pressing public health challenges of the 21st century, with significant implications for both physical and psychological well-being. This review synthesizes current evidence on the multifactorial causes, health consequences, and management strategies for childhood and adolescent obesity. The development of obesity in early life is shaped by complex interactions among genetic, epigenetic, environmental, behavioral, and socioeconomic factors. Key contributors include poor dietary habits, sedentary lifestyle, maternal and prenatal influences, and psychosocial determinants. The consequences of pediatric obesity extend far beyond excess adiposity, encompassing cardiometabolic disorders, orthopedic problems, respiratory dysfunction, and psychosocial impairments. Effective management requires an individualized, multidisciplinary, and family-centered approach. Evidence supports multicomponent interventions that integrate dietary modification, increased physical activity, behavioral and psychological support, and—in selected cases—pharmacological or surgical treatment. Pharmacotherapy with glucagon-like peptide-1 receptor agonists, such as liraglutide and semaglutide, has shown promising results in adolescents with severe obesity, while bariatric surgery remains a viable option for refractory cases. Emerging personalized, pathophysiology-informed strategies and novel pharmacologic agents offer new opportunities for targeted intervention. Addressing pediatric obesity necessitates long-term, comprehensive, and sustainable efforts that engage healthcare systems, families, and communities to mitigate the escalating burden of this condition.