Adolescence is a time of exceptional physical health juxtaposed against significant psychosocial and weight-related problems. The study included 241, 10-to-13-year-old youth with autism spectrum disorder (ASD, N = 138) or typical development (TD, N = 103). Standardized exams measured pubertal development, height (HT), weight (WT), heart rate (HR), blood pressure (BP) and Body Mass Index (BMI). Analysis of Variance showed no significant between-group differences for HT, WT, HR, or BP (all p > 0.05). There was a significant difference in BMI-percentile between the groups (F(1,234) = 6.05, p = 0.01). Using hierarchical linear regression, significant predictors of BMI-percentile included diagnosis, pubertal stage and socioeconomic status. Pre-to-early pubescent children with ASD evidence higher BMI percentiles compared to youth with TD suggesting they may be at heightened risk for weight-related health concerns.