Background: Obesity especially visceral obesity is an important independent risk factor for the development of gastro-esophageal reflux disease (GERD) and, Barrett's esophagus (BE). Aim: In this work, we aimed to evaluate serum adiponectin level in obese patients with GERD and Barrett's oesophagus as well as highlight its role in early predicting Barrett's oesophagus. Materials and Method: 120 participants with BMI ≥ 25 were involved in this case control study. They were grouped into Group I: 30 participants of coincided BMI, age and gender as obese controls;Group II:included 60 patients with GERD, and Group III: 30 patients with BE. All participants were subjected to clinical evaluation, Upper endoscope and serum adiponectin by ELISA. Biopsy with histopathological evaluation to confirm BE was done. Results: Significantly lower plasma adiponectin levels were detected in BE patients compared to GERD patients and the control group with significantly higher plasma adiponectin levels in GERD compared to controls. ROC analysis showed that AUC was 0.958 at a cut-off point ≤ 0.74, sensitivity and specificity were (90.0% and 95.0% respectively) for prediction of BE in GERD patients. Lower adiponectin levels were found in patients with large sliding hiatus hernia, long-segment Barrett as well as patients with high-grade dysplasia. Multivariate analysis displayed that adiponectin could be an independent predictor for BE. Conclusion: Obesity is a substantial risk for the development of GERD and BE. Adequate weight control is an important step for the prevention ofBE. Additionally, adiponectin serum levels could be a reliable non-invasive biomarker for early prediction of BE.