Obesity and insulin resistance may lead to nonalcoholic fatty liver disease (NAFLD) in adolescents. Triglyceride-glucose-derived obesity indices reflect the combination of insulin resistance and metabolic disorders. Research on the relationship between adolescent NAFLD and triglyceride glucose–waist circumference (TyG-WC), triglyceride glucose–waist-to-height ratio (TyG-WHtR), triglyceride glucose–body mass index (TyG-BMI), and triglyceride-glucose weight-adjusted waist index (TyG-WWI) remains extremely limited. This study utilized data from the 2017 to 2020 National Health and Nutrition Examination Survey, which involved individuals aged 12 to 19 years. Two groups of participants were created based on the controlled attenuation parameter obtained from liver ultrasound transient elastography: those diagnosed with NAFLD and those without NAFLD. The study examined the relationship between adolescent NAFLD and the triglyceride-glucose (TyG) composite body measurement indicator using multivariate logistic regression, smooth curve fitting, and receiver operating characteristic. A total of 678 subjects were included, comprising 115 cases in the NAFLD group and 563 cases in the non-NAFLD group. The fully adjusted multivariate logistic models TyG-WC, TyG-WHtR, TyG-BMI, and TyG-WWI all showed significant positive correlations with NAFLD ( P < .001). Specifically, each unit increase in TyG-WHtR was associated with a 6-fold increase in the risk of fatty liver disease (95% confidence interval: 6.03 [3.82–9.52]). The top 3 area under the curve values were obtained by TyG-WC (0.8833), TyG-WHtR (0.8761), and TyG-BMI (0.875). TyG-WC, TyG-WHtR, TyG-BMI, and TyG-WWI are significantly associated with NAFLD risk in adolescents aged 12 to 19 years and may hold clinical value for predicting NAFLD in this population.