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Body fat distribution play a key role in metabolic syndrome pathogenesis. TC and DEXA imaging allow us to differentiate abdominal subcutaneous from visceral fat. Ultrasound (US) imaging, widely used in thyroid assessment, further allows us to differentiate other abdominal layers: superficial and profound subcutaneous, pre-peritoneal, omental and perirenal (retroperitoneal) fat. Our aim was to measure these layers and correlate them with anthropometric parameters and metabolic syndrome (MS) clinical features. US (GE logic E©) measurement of different abdominal fat layers were done at 397 consecutive patients (28% male 72% female) that came for conventional US for any reason. 12 MHz linear probe for superficial layers and 5 MHz convex probe for intra-abdominal layers assessment have been used. All measures were done at L4 vertebra level to allow comparison with DEXA/CT. Age (16-77 y.o), BMI (22,3-44,7 Kg/m2), abdominal perimeter, % body fat, glucose, HDL, LDL, total cholesterol, triglycerides and HOMA index were recorded. MS criteria were assessed using ATPIII classification. Women showed higher (superficial and profound) subcutaneous fat depots, while men had bigger omental and perirenal fat (p