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There is inconsistency regarding the effects of cadmium exposure on liver function between the positive results found in animal studies and the negative results highlighted in epidemiological studies. We investigated whether environmental cadmium exposure is associated with an elevation in serum liver enzyme activity in Korean adults.This cross-sectional study evaluated adult participants without liver disease from the Korean National Health and Nutrition Examination Survey for 2008-2009. Multiple linear regression was conducted to investigate the association between blood cadmium concentration and the serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) adjusting for age, sex, body mass index and the amount of alcohol consumption. Subjects were stratified into quartiles by their cumulative cadmium exposure rank. We estimated the multivariate-adjusted ORs for liver enzyme elevation using logistic regression models with the first quartile as the reference group.Total number of the subjects in the analysis was 3914. The blood cadmium concentrations were significantly associated with liver enzyme levels (AST, β=2.677, p value0.0001; ALT, β=3.696, p value0.0001; ALP, β=11.730, p value0.0001). As the cadmium levels approached higher quartiles, the ORs for an elevated AST, ALT and ALP was increased significantly.Environmental cadmium exposures are associated with an elevation in serum liver enzyme levels in Korean adults.