Lane JCE, Butler KL, Poveda‐Marina JL, et al. - Experts aspired to explore whether having an overweight or obese range body mass index (BMI) at time of beginning school is correlated with increased fracture incidence in childhood. Data from 296 primary care centers representing 74% of the regional pediatric population have been obtained. In total, 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (± 6 months) between 2006 and 2013 were involved, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. An association was found between elevated preschool BMI and increased fracture incidence in childhood. At school, obese BMI was associated with 70% and 20% excess risk of lower and upper limb fractures during childhood. Overweight BMI was associated with 40% and 10% excess risk of lower and upper limb fractures. The association of increased incidence of fractures was independent of age, socioeconomic status, gender and nationality.