BACKGROUND AND OBJECTIVE: Visceral Adipose Tissue (VAT) which is associated with a higher risk of Metabolic Syndrome (MS) shows adverse effects on bone health. Moreover, MS is associated with high concentrations of serum estradiol (E2), which is essential for bone, as it inhibits bone resorption. This study aimed to investigate the impact of visceral fat and serum E2 levels on bone health markers (vitamin D, C-terminal peptide, Ca and BMD) in obese women with and without MS. MATERIALS AND METHODS: This cross-sectional study was conducted on 64 obese women, with and without MS. Waist Circumference (WC) was measured in cm. Bone Mineral Density (BMD) was assessed by energy X-ray absorptiometry (DEXA), VAT was evaluated using Body Composition Analyzer "Tanita". Serum E2, C-terminal peptide and vitamin D (Vit. D) were assessed using ELISA technique. Serum calcium (Ca), triglyceride (TG), total cholesterol (Tchol), High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL) and Fasting Blood Sugar (FBS) were also assessed. RESULTS: In women with MS, VAT showed significant positive correlations with Body Mass Index (BMI), WC and FBS. Whereas, in women without MS, VAT showed significant positive correlations with BMI, TG, age and significant negative correlation with E2. On the other hand, in women with MS, estradiol (E2) had significant negative correlation with age and significant positive correlations with BMD, BMI, FBS and body weight. While, in obese women without MS, it had significant negative correlations with Ca, VAT, age and systolic blood pressure. CONCLUSION: In obese women with MS, increased VAT, higher BMI, older age and low E2 levels have clinical significance and hence, they should be considered when predicting bone health risk.