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Summary: Multiple skin tags appear associated with abnormalities in glucose/insulin metabolism. Clinical and metabolic glucose/insulin characteristics of men with multiple (8 or more) skin tags on the neck were compared with a control group with few or none. Both groups were divided in two subgroups according to normal or abnormal laboratory findings. In the study subgroup with normal laboratory findings the number of skin tags varied from 8-33, whereas in those with abnormal laboratory findings the range was 9-65. Eight or more skin tags were related with statistically significant laboratory glucose/insulin abnormalities: basal hyperinsulinemia (p<0.002), postprandial hyperinsulinemia (p<0.003), and postprandial hyperglycemia (p<0.01). In the multiple skin tag group 77 % had diverse laboratory abnormalities, including insulin resistance, basal hyperinsulinemia, postprandial hyperinsulinemia, glucose intolerance or type 2 diabetes, in contrast with the control group, where only 33 % showed laboratory abnormalities. One-third of the study group had acanthosis nigricans. Only 15 % of patients with metabolic abnormalities did not show any cutaneous expression of glucose/insulin alterations (9 or more skin tags on the neck, acanthosis nigricans, or waist circumference greater than 95 cm). Multiple skin tags were more sensitive than acanthosis nigricans in identifying those with alterations in the glucose/insulin metabolism (77 vs. 32 % respectively), although less specific (68 vs.100%). Multiple skin tags should raise suspicion of insulin resistance or hyperinsulinemia.