Sub-Saharan Africa is afflicted by high hypertension prevalence that is expected to rise even further along with increasing obesity rates. The present study aimed to investigate the role of visfatin in obesity and to explore associations of visfatin with markers of endothelial function and hemodynamics in African women compared to a well-matched white sample. The present study involved urban African (n = 102) and white (n = 115) women from South Africa, individually matched for age and BMI. We measured blood pressure, cardiac output, and arterial compliance noninvasively, and analyzed visfatin as well as circulating markers of vascular function and inflammation in serum. Serum visfatin concentration did not differ between African and white women. Visfatin was unrelated to obesity in African women but positive associations for total and abdominal obesity were found in white women. Age- and obesity-adjusted univariate and multivariate analyses revealed significant positive associations of visfatin with endothelin-1 and fibrinogen in African women. Identical analyses in white women indicated a positive association of visfatin with C-reactive protein and von Willebrand factor. Our findings suggest a possible role of visfatin in the cardiovascular system that seems to be independent of obesity in the African women.