Background: Insulin resistance, pre-diabetes, and obesity have all been linked to excess adiposity. Proinflammatory adipokine visfatin is thought to play a key role in type 2 diabetes inflammation. Objective: This study aimed to estimate visfatin level among prediabetic obese patients and to observe and detect the interplay between visfatin, insulin resistance and obesity. Patients and methods: 96 adult subjects were studied in case-control research at Internal Medicine Department and Clinical Pathology Department, Zagazig University Hospital. The study was carried out from January 2021 to November 2021. Subjects were divided into 3 groups: Group (1) included 24 healthy individuals as a control group, group (2) included 48 prediabetic individuals and group (3) that included 24 patients type 2 diabetes who never been treated in any of these. Serum visfatin was assessed in all participants. Results: Diabetes mellitus (DM) patients had higher visfatin levels than those with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Visfatin had a significant positive correlation with BMI, WC, FBS, PPS, HA1c, LDL, fasting insulin, and HOMA IR, while HDL had a significant negative correlation. Conclusion: Visfatin levels were significantly linked to type 2 diabetes. HOMA-IR, fasting insulin, and BMI all showed a strong positive correlation with visfatin levels, suggesting that it may be a useful biomarker for detecting type 2 diabetes.