Assessing the complexity of pediatric obesity cases is a key step in optimizing the care pathway. Using an approach similar to the model proposed by the Haute Autorité de santé (HAS) for adults in 2022, we have developed two tools: Ivop, which stands for “pediatric obesity vulnerability index,” used to assess vulnerability, and Escop, which stands for “estimation of the complexity of pediatric obesity cases,” used to estimate complexity (combining the degree of excess weight and the Ivop score).The objective of our study is to describe and evaluate the relevance of these tools. Our study was conducted among 53 children followed at the Pediatric Obesity Specialized Center (CSO) of the Bordeaux University Hospital (CHU) in 2022. Correlation analyses were conducted to compare the Ivop with the Épices score (assessment of health vulnerability and inequalities in health examination centers (CES)) and the Escop with an expert opinion established by CSO professionals. A moderate positive linear correlation was found between Épices and Ivop (r=0.49). A significant association was found between Escop and the level of complexity assessed by the expert opinion (r=0.6; p<0.0001). The ROC (Receiver Operating Characteristic) curves show an area under the curve (AUC) of 0.80 for distinguishing complexity levels 1 to 3 versus 4 and 5, and an AUC of 0.73 for levels <5 versus ≥5. Despite certain methodological limitations, the Ivop appears to be a sensitive and reproducible tool, allowing for a more comprehensive and nuanced assessment of vulnerability than the Épices score, which was designed to assess the socioeconomic situations of adults. The Escop tool appears to be an effective means of estimating the level of complexity.