Weight misperception has been linked to health risk and mental health indicators among adolescents, and may contribute to unhealthy weight changes and decreased success of obesity prevention programs. The objective of this research is to determine the dose-response association of weight misperception (WM) with weight control practices and sociodemographic characteristics in a sample of adolescents from Harris County, TX. Participants included 1552 high school students from the 2013 Harris County Youth Risk Behavior Survey (YRBS) administered by Harris County Public Health’s Nutrition and Chronic Disease Prevention Division. Weight misperception was classified using five categories for degree of agreement between perceived and reported actual weight (RAW), ranging from greatly underestimated to greatly overestimated. Multivariable adjusted logistic regression analyses were utilized to evaluate associations of weight misperception with weight control practices. Results indicate 8.8%, 26.7%, 52.1%, 11.2%, and 1.3% of respondents greatly underestimated, moderately underestimated, correctly perceived, moderately overestimated, and greatly overestimated their weight, respectively. WM was prevalent across sociodemographic categories, with females more likely to overestimate, and males more likely to underestimate, their weight; a similar pattern was observed for White vs. Black students. Among respondents in the normal weight, overweight, and very overweight RAW categories, 28.5%, 9.8%, and 7.2% reported trying to gain weight, respectively. For those in the overweight and very overweight categories, 12% and 8.5% reported trying to maintain their weight, respectively. The odds of trying to lose weight were highest among students who moderately overestimated their weight [OR = 6.09, 95% CI (2.75, 13.47), p = 0. 965] and lowest among those who greatly overestimated it [OR = 1.02, 95% CI (0.28-3.79), p = 0. 965] compared to those who correctly perceived their weight. Weight misperception is common among high school students in Harris County, TX. This issue has important implications for obesity as well as eating disorder prevention and treatment. Education on healthy body weight may increase awareness of actual weight status and improve receptivity to obesity interventions.