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Kreuk was born in Vancouver, British Columbia. Her father, Peter Kreuk, is of Dutch descent; her mother, Deanna Che, is of Chinese descent, but was born in Indonesia; her maternal grandmother was born in Jamaica of Chinese descent. Both parents are landscape architects. She has a sister named Justine, who is about five years younger. Kreuk trained in karate and gymnastics at the national level until high school but quit in 11th grade due to scoliosis. She attended Edith Cavell Elementary School (vide Edith Cavell) and Eric Hamber Secondary School in Vancouver.

Kreuk planned to study psychology, environmental science, or forensic science at Simon Fraser University, when a casting director for the CBC TV series Edgemont contacted her secondary school, looking for an Asian girl to play the part of a Chinese Canadian, Laurel Yeung, on show, which was shot in Vancouver. Kreuk's drama teacher convinced Kreuk, who had no previous acting experience other than in musicals at her high school, to audition for the role, which she won.