Objectives To examine disordered eating and associations with health-related quality of life (HRQOL) in rural overweight/obese (OW/OB) children. Methods Cross-sectional analyses were conducted with 272 rural OW/OB children aged 8-12 years (M = 10.36; SD = 1.39). Child anthropometrics, demographics, disordered eating attitudes, unhealthy weight control behaviors (UWCBs), and HRQOL were measured. Relationships between these variables were analyzed using bootstrapped multiple linear regressions. Results Clinically significant disordered eating attitudes were endorsed by 17% of the sample, and the majority endorsed UWCBs. Disordered eating attitudes and weight status were the most common predictors of HRQOL. Disordered eating attitudes and UWCBs were negatively related to emotional HRQOL but were unrelated to social, school, or physical HRQOL. Conclusions Disordered eating is a serious and relevant problem in OW/OB children living in rural areas and may be indicative of impairments in emotional functioning. Early intervention may reduce the risk for eating disorders and associated negative sequelae. © 2014 The Author.