Insulin resistance (IR) is identified as an impaired biologic response to insulin stimulation of target tissues, primarily liver, muscle and adipose tissue. Insulin resistance impairs glucose disposal, resulting in a compensatory increase in beta-cell insulin production and hyperinsulinemia. There was a positive correlation between insulin, homeostatic model assessment of insulin resistance (HOMA-IR) values and acne vulgaris. Nesfatin-1 is a novel peptide hormone that suppresses appetite through its actions in the central nervous system. It has anorexigenic effects and it has a major regulatory role in food intake, energy homeostasis, water intake and body temperature. The current study aimed to assess and measure the serum level of nesfatin-1 and IR in acne vulgaris patients and compare their levels in healthy controls. Fifty patients suffering from acne vulgaris, in addition to thirty apparently healthy individuals of matched age, sex and BMI as a control group. Serum insulin,FBS and nesfatin levels were estimated using commercially available ELISA kits. Our findings suggest that, nesfatin-1 is associated with the susceptibility of development of acne vulgaris and HOMA-IR has a role in the disease pathogenesis and its severity.