Background <p>This study aimed to identify and characterize the sedentary behavior (SED) and breaks accumulation patterns of children and adolescents and investigate the associations of these derived patterns with adiposity indicators.</p> Methods <p>A total of 348 children and 562 adolescents from China participated in this study. Accelerometers were used to measure the bouts of SED and breaks. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), and fat mass index (FMI). Latent profile analysis was used to identify the SED and breaks accumulation patterns on the basis of 11 compositions of SED bouts and breaks. Mixed-effects multivariable linear regression models were used to analyze the associations of accumulation patterns with adiposity indicators.</p> Results <p>Four accumulation patterns were identified in children: “prolonged sitters” (<i>N</i> = 77, 22.1%), “shortened sitters” (<i>N</i> = 90, 25.9%), “LPA breakers” (<i>N</i> = 69, 19.8%), and “MVPA breakers”(<i>N</i> = 112, 32.2%). “MVPA breakers” had significantly lower BMI z-score, FM%, and FMI than “prolonged sitters.” No significant differences in adiposity indicators were observed among the other three patterns. In adolescents, “prolonged sitters” (<i>N</i> = 250, 44.5%), “moderate sitters” (<i>N</i> = 211, 37.5%), and “breakers” (<i>N</i> = 101, 18.0%) were identified. “Breakers” had the lowest BMI z-score, FM%, and FMI among the three groups, followed by “moderate sitters” and “prolonged sitters.”</p> Conclusion <p>Different accumulation patterns of SED and breaks were identified for children and adolescents in China. Among them, “MVPA breakers” and “Breakers” are most beneficial to maintain a normal weight status. Health promotion efforts could consider increasing MVPA and decreasing SED time for children and restricting SED to at least 30&#xa0;min for adolescents to improve their adiposity indicators.</p>