Background: Obstructive sleep apnea (OSA) is a common problem estimated at 2-5% in the school-aged children. As obesity prevalence is increasing universally, OSA is estimated to be higher than their lean children. Obesity related OSA is increasing in all age groups including younger children. The aim of this study is to focus on the importance of OSA among obese preschool children and to determine what risk factors are associated with OSA. Methods: A retrospective chart review for children ≤6 years is identified from tertiary centre in Saudi Arabia who had a polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age. OSA was diagnosed if the obstructive apnea hypopnea index (OAHI) was greater than 1 event per hour. Results: There were 4 children identified; the mean age was 4.5 years meaning BMI was 28(SD ± 1.2). the prevalence of OSA in those children was high. Conclusion: Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness should facilitate referral for a PSG, especially in resource-limited settings.