Early life prevention of obesity and associated metabolic disease is necessary to address the current obesity epidemic. Latino children have a higher risk of obesity, and associated comorbidities such as hypertension than Caucasian children. This study focuses on perinatal childhood and maternal risk factors associated with prehypertension and hypertension prior to age 9 in an urban Latino cohort. A cohort of low income, US born Latino children (n = 131) in San Francisco was followed from birth. Annual assessments were conducted including child dietary intake, anthropometrics, and blood pressure measurements. Maternal body mass index and depressive symptoms were assessed concurrently. Leukocyte telomere length was assessed at age 4 and 5 in children. Rapid infant weight gain (odds ratio (OR) 7.25, 95% confidence interval (CI) 1.33–39.38) and prenatal maternal clinical depression (OR 6.70 95% CI 1.15–39.16) were associated with prehypertension/hypertension before age 9. Early life obesity and leukocyte telomere length were not associated with childhood hypertension. Rapid infant weight gain and exposure to prenatal maternal depression are predictive of childhood prehypertension/hypertension before age 9 in low income, US-born Latino children. The perinatal period is an important time point to target for prevention of childhood hypertension.