Background: Pre-diabetes is the stage before Diabetes mellitus (DM) there are two forms of prediabetes Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Many inflammatory markers have been found to be related to Pre-diabetes, such as interleukin-1β (IL-1β), visceral adiposity index, insulin resistance, and insulin secretory states and serum levels of Apo- β lipoproteins in the pathogenesis of pre-diabetic state in obese persons. AIM OF THE WORK: To assess the role of Interleukin-1β, visceral adiposity index, insulin resistance, and insulin secretory states and serum levels of Apo- β lipoproteins in the pathogenesis of pre-diabetic state in obese persons. Patients and Methods:  This study is a prospective one that was carried out on one hundred and twenty (120) patients attending to internal medicine outpatient clinic and inpatient department of internal medicine, Al-Azhar university hospital, Damietta. The populations of the study were classified into (60) obese persons and (60) non obese persons. All were subjected to full history and Clinical examination, Laboratory tests include HbA1c, Fasting blood sugar, post prandial glucose level, Liver  Function Test (ALT, AST, serum albumin, bilirubin, and GGT), Renal Function Test (Creatinine, Urea, Uric Acid), Lipid Profile (Cholesterol, Triglycerides, HDL Cholesterol, and LDL Cholesterol) and  High  sensitive  C-reactive proteins, OGTT, Visceral adiposity index based on (WC, BMI,TG, and HDL-C, it estimates the visceral adiposity functionality, Male VAI=(WC/{39.68+(1.88×BMI)})×(TG/1.03)×(1.31/HDL-C), Female VAI=(WC/{36.58+(1.89×BMI)})×(TG/0.81)×(1.52/HDL-C), serum  Interleukin-1β levels and Apo β-lipoproteins. Results: Our study showed that there was statistically significant increase in VAI, IL-1β, Apo- β lipoproteins, ALT, AST, Cholesterol, TG, LDL, HDL, S. insulin, HOMA and HbA1c in group I  in comparison to group III, on the other hand there was statistically significant increase in VAI, IL-1β, Apo- β lipoproteins, ALT, AST, Cholesterol, TG, LDL, HDL, S. insulin and HOMA in group II  in comparison to group IV and there was statistically significant increase in IGT in group I  subjects in comparison to group III subjects. Conclusion: IL-1β and Apo- β lipoproteins consider as a risk factor in the pathogenesis of pre-diabetes in obese persons, which may progress to Diabetes So Therapy targeting IL-1β may ameliorate the condition and VAI is associated with insulin resistance.