In order to properly assess the risk of type 2 diabetes and cardiovascular disease (CVD), it is vital to consider regional body fat distribution in addition to overall obesity. Epidemiological studies have clearly shown that abdominal obesity is the form of overweight/obesity associated with the highest risk of complications. However, most epidemiological studies have evaluated body fat distribution using simple and inexpensive anthropometric tools such as waist circumference. The development of imaging techniques such as computed tomography and magnetic resonance imaging has enabled intra-abdominal (visceral) and subcutaneous fat to be measured with a high degree of accuracy. Using these techniques, researchers have been able to determine—for any given amount of total body fat—that individuals with a selective excess of intra-abdominal fat are significantly more likely to develop cardiovascular or diabetic complications than subjects with excess subcutaneous fat. More importantly, the amount of intra-abdominal fat has been shown to predict the risk of type 2 diabetes and total mortality. Imaging techniques have therefore enhanced our understanding of the importance of intra-abdominal fat to the clustering abnormalities of the metabolic syndrome.