Reducing sedentary behavior has been proposed as a modality for treating pediatric overweight. Small randomized controlled trials suggest that targeting reductions in sedentary behavior, rather than targeting increases in physical activity, can be an effective modality in addressing this problem. In some cases, targeting reductions in sedentary behavior has been shown to be more effective than targeting physical activity directly, resulting in greater reductions in overweight measures such as body mass index and percent overweight. Reductions in sedentary behavior may allow more opportunity to reallocate this time to physical activity. It also may result in reduced intake of high-calorie foods. This article reviews the evidence in the literature for targeting reductions in sedentary behavior as a modality in treating pediatric overweight.