The association of height, weight, pubertal stage, calcium in- take, and physical activity with bone mineral density (BMD) was evaluated in 500 children and adolescents (205 boys and 295 girls), aged 4-20 yr. The BMD (grams per cm2) of lumbar spine and total body was measured with dual energy x-ray absorptiometry. Lum- bar spine volumetric BMD was calculated to correct for bone size. BMD and volumetric BMD increased with age. During puberty, the age-dependentincrementwashigher.Afteradjustmentforage,the Tanner stage was significantly associated with all three BMD variables in girls and with spinal BMD in boys. In boys, positive correlations were found between BMD and both calcium intake and physical activity after adjustment for age. Stepwise regression analysis with weight, height, Tanner stage, calcium intake, and physical activity as determinants with adjustment for age resulted inamodelwithTannerstageingirlsandweightinboysforallthree BMD variables. The major independent determinant of BMD was the Tanner stage in girls and weight in boys. (J Clin Endocrinol Metab 82: 57-62, 1997)