Background: Psoriasis is a common chronic immune mediated papulosquamous disease that affects 2-3% of the population. The exact cause of psoriasis is still unclear, but it is considered a disease of dysregulated inflammation which is driven and maintained by interaction among multiple components of immune system in genetically predisposed individuals. Adipose tissue is an active endocrine organ contributing to the regulation of multiple metabolic pathways via self-produced bioactive products called adipokine. Adiponectin of adipose origin has the highest circulating concentration among the known adipokines. Adiponectin regulates skin inflammation especially IL-17-related psoriasiform dermatitis. Objective: This study was aimedto estimate the serum level of Adiponectin and detect its correlation with activity of psoriatic patients. Patients and Methods: This case control study included a total of 50 patients with psoriasis and 50 healthy individuals, attending at Outpatient Clinic, Department of Dermatology, Venereology and Andrology in collaboration with Department of Clinical Pathology, Faculty of Medicine, Zagazig University Hospitals. This study was conducted between November 2019 to November 2020. Psoriasis severity was classified according to psoriatic area and severity index (PASI) score. Serum level of adiponectin was determined by ELISA for both groups. Results: The results revealed that control group had significantly higher level of adiponectin than psoriasis patients. There was a negative significant correlation between adiponectin and Psoriasis Area and Severity Index (PASI score) (p <0.001**). Sensitivity of adiponectin in diagnosis of psoriasis was 94%, specificity was 90% and accuracy was 92%. Conclusion: Adiponectin measurement in serum of patients with psoriasis provides a tool for monitoring disease activity.