Blood pressure to height ratio (BPHR ) has been suggested as a simple method for screening children with hypertension, but its discriminatory ability in young children is not as good as that in older children. Using data of 89,664 Chinese children aged 7 to 11 years, the authors assessed whether modified BPHR (BP :eHT 13) was better than BPHR in identifying young children with hypertension. BP :eHT 13 was estimated as BP /(height+7×(13−age in years)). Using Youden's index, the thresholds of systolic/diastolic BP :eHT 13 for identifying prehypertension and hypertension were 0.67/0.44 and 0.69/0.45, respectively. These proposed thresholds revealed high sensitivity, specificity, negative predictive value, and area under the curve (AUC ), ranging from 0.874 to 0.999. In addition, BP :eHT 13 showed better AUC s and fewer cutoff points than, if not similar to, two existing BPHR references. BP :eHT 13 generally performed better than BPHR in discriminating BP abnormalities in young children and may improve early hypertension recognition and control.