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Background: Breast density and obesity are independent risk factors of breast cancer, but there are few studies on associations of three-dimensional breast density with abdominal adiposity. In this study, we studied the association between abdominal adiposity and three-dimensional breast density using digital mammography in Korean women. Methods: Cross-sectional study was performed on 64 women who underwent health checkup in a university hospital. A questionnaire was conducted to assess past history, medication history, social history, menstrual history, fertility, and use of hormone replacement therapy. We used weight, body mass index, waist circumference, visceral fat area and subcutaneous fat area as indicators of obesity and measured breast density(dense volume, percentage dense volume) using a digital mammography. We examined the associations between breast density and obesity. Results: Multiple linear regressions were used to analyze associations between body mass index, waist circumference, visceral fat area, subcutaneous fat area and outcomes: dense volume and percentage dense volume. In postmenopausal women, waist circumference showed statistically significant association with dense volume (β = 0.012, P < 0.001) while visceral fat area was inversely associated with percentage dense volume (β = -0.002, P < 0.001). Among premenopausal women, visceral fat was associated with dense volume (β = 0.003, P = 0.046), however, none of the factors showed any significant association with percentage dense volume. Conclusion: we studied associations between three-dimensional breast density, using digital mammography, and abdominal adiposity in Korean women. In this study abdominal adiposity affected breast density in both premenopausal and postmenopausal women. [ABSTRACT FROM AUTHOR]