The aim of our study was to evaluate the relationship between the importance of visceral fat measured by tomodensitometry and the metabolic disturbances in hirsute women. It is a prospective study where 52 women were explored for hirsutism. They underwent a clinical and biological examination, as well as an abdominal tomodensitometry at the 4th and 5th lumbar spine level to measure the area of visceral fat (VF) and sub-cutaneous fat (ScF). In the 25 patients with VF predominance (VF/ScF > or = 0.2), age, body mass index (BMI), fasting insulin, (12h) and the prevalence of dyslipidaemia were significantly higher compared with women with ScF predominance (VF/ScF < 0.2). There was a positive correlation between VF and age. BMI, waist to hip ratio, 12h and triglyceridemia. In conclusion, hirsute women with visceral fat predominance are at higher risk to develop the insulin resistance syndrome. So, preventive measures against cardio-vascular risk factors, like overweight, must be a part of the treatment.