Adipocyte fatty acid-binding protein (A-FABP) is a newly recognized adipokine that plays a role in the development of obesity and insulin resistance in adults. We investigated the association between A-FABP levels and obesity and insulin resistance in school-aged children. One hundred sixty-one 9-year-old Korean children (80 boys and 81 girls) voluntarily participated in this study at school-based health examinations. Weight, height, waist circumference, and blood pressure were measured. Fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, insulin, and A-FABP levels were measured; and insulin resistance was estimated by the homeostasis model assessment. Subjects with higher body mass index (BMI) percentiles had correspondingly higher concentrations of A-FABP in both boys and girls. Subjects within the highest quartile of A-FABP levels had correspondingly poor metabolic risk profiles (BMI, waist circumference, triglycerides, high-density lipoprotein cholesterol, fasting insulin, and homeostasis model assessment of insulin resistance) compared with those in the lowest A-FABP quartile (P < .01). Serum A-FABP concentrations were significantly correlated with BMI (r = 0.58, P < .01) and waist circumference (r = 0.51, P < .01). However, the significant correlation between serum A-FABP and insulin resistance faded after adjustment for BMI. Adipocyte fatty acid-binding protein was closely associated with obesity or abdominal obesity in children; however, the independent relationship between A-FABP and insulin resistance in children is still unclear and remains to be determined.