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The aim is to present the results of the anthropometric study of the 6th round of The Growth Surveillance Study of Lithuanian first-grade students, comparing them between sex, different age groups and 10 Lithuanian counties.Material and methods. Since 2008, every three years, scientists of the Health Research Institute, participating in the WHO European Childhood Obesity Surveillance Initiative, have been organizing the Lithuanian Children's Growth Surveillance Study, during which they interview parents of first-grade students and measure the height and weight of children. The study is conducted in accordance with the international protocol and methodology and is carried out in randomly selected schools of all ten counties. After receiving written consent from school principals, all first-grade students at those schools are invited to participate in the study. The sample of first-grade students representing Lithuania is constant at each stage of the study – 5800 children are selected. In 2023 the Surveillance study involved 94 schools, measuring 3182 first-grade students whose parents signed an informed consent form (response rate 53%). The survey was conducted by a trained research team. Based on height and weight measurements, body mass index (BMI) was calculated for each subject. Students were divided into BMI groups according to the cut-offs of the International Obesity Task Force (IOTF).Results. Over the 15 years of Surveillance, the average height, weight and BMI of first-grade students increased, with height changing the most. A slightly higher proportion of children with normal body weight was found among seven- and eight-year-old boys compared to girls. One in five boys and one in four to five girls were overweight, including obesity, but no significant differences were found when assessing the distribution of boys and girls in different age groups by BMI. The prevalence of overweight and obesity among first-grade students varied statistically significantly between counties.Conclusions. The sixth round of the Surveillance reveals negative trends: the proportion of first-grade students with normal weight is decreasing and the proportion of first-grade students with elevated body weight is increasing.