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Introduction: It is well-established that obesity plays a significant role in the development of metabolic syndrome. Visfatin is a novel adipocytokine predominantly secreted in adipose tissue, associated with a wide range of biological effects including glucose and lipid metabolism. Visfatin levels are significantly linked to inflammation and the development of obesity-related metabolic disorders. Unfortunately, the roles of visfatin in obesity, particularly in the Indian population, are scarce. Aim: To study the role of serum visfatin in diagnosing metabolic syndrome in overweight and obese adults. Materials and Methods: A comparative cross-sectional study was conducted at the Department of Biochemistry, Tomo Riba Institute of Health and Medical Sciences, Naharlagun, Arunachal Pradesh, India, between September 2022 and October 2023. A total of 200 subjects (50 controls, 50 overweight individuals, 50 obese individuals without metabolic syndrome, and 50 obese individuals with metabolic syndrome), aged 20-70 years, were enrolled as study participants. Anthropometric parameters, lipid profiles, and fasting glucose were analysed using an auto analyser. Serum visfatin levels were measured by Enzyme-linked Immunosorbent Assay (ELISA). Statistical analysis was performed using the t-test, and categorical data were analysed using the Chi-square test. Correlation analysis was done by Pearson's correlation at a significance level of 5%. Results: The control group consisted of 17 males and 33 females with a mean age of 41.5±13.4 years, the overweight group consisted of 13 males and 37 females with a mean age of 37.1±10.9 years, the obese without metabolic syndrome group consists of 16 males and 34 females with a mean age of 40.6±12.7 years, and obese with metabolic syndrome group had 23 males and 27 females with a mean age of 42.0±9.2 years. Serum visfatin levels (ng/mL) were significantly elevated in the overweight (1.7±0.3), obese without metabolic syndrome (4.3±3.2), and obese with metabolic syndrome (10.9±6.6) groups compared to the controls (1.0±0.2). Serum visfatin levels were positively correlated with Body Mass Index (BMI) (r=0.51, p