Measures of central obesity, such as waist circumference, waist to hip ratio and waist to height ratio,  have been suggested to be more closely associated with subsequent chronic diseases and cardiovascular risk (CVR) than the body mass index (BMI = Kg/m²),  measure of global obesity. Over the past two decades several hundred studies have compared anthropometric parameters of obesity to evaluate which of them is the best in detecting adverse CVR profile. The purpose of this review is to provide an overview of the current evidence focused on the association between measures of global and abdominal obesity and several CVR factors, such as high blood pressure, type 2 diabetes mellitus and dyslipidemia, and to summarize results from recent prospective studies on the body size measures as predictors of cardiovascular disease outcomes. An overview of performance of these associations and cut-off values to predict CVR within and between different ethnical populations was also provided. The clinical utility of abdominal measures in clinical practice for the effective management of obese patients in resource poor-settings and in feasible routine biochemical testing was discussed.