Background: Metabolic syndrome (MetS), a cluster of cardiometabolic risk factors, consider as a manifestation of obesity. However, a proportion of obese patients do not develop MetS. The aim of our study was to deter-mine whether concentration of plasma adiponectin and leptin differ between metabolic unhealthy obese (MUO) patients and comparable age-and sex-matched control groups. Methods: In this case-control study, we assigned 51 obese patients with MetS (MUO) in cases group and 102 metabolic healthy obese (MHO) and normal weight metabolic healthy subjects matched for age and gender to cases in control groups. The study was conducted between December 2014 and February 2016 in the Endocri-nology Research Center of Tehran University of Medical Sciences, Tehran, Iran. We measured serum adi-ponectin, leptin, their ratio, and body composition in all subjects. Results: No significant differences were observed between MHO and MUO in term of total fat mass and trunk fat (P>0. 05). Compared to MHO and normal weight metabolic healthy subjects, MUO subjects had low-er levels of plasma adiponectin (P<0. 001) and lower plasma adiponectin to leptin ratio (P<0. 001) and a higher level of plasma leptin (P<0. 002). A Receiver Operator Characteristic curve was used to identify the ability of adiponectin and leptin level to predict the MetS. The area under the Receiver Operator Characteristic curve was 0. 66 (P<0. 01), 0. 73 (P<0. 001) and 0. 75 (P<0. 001) for leptin, adiponectin, and adiponectin/leptin ratio levels respectively. Conclusion: Our study introduced adiponectin and leptin as INDICATOR of MetS and obesity respectively.