Anthropometric indicators of abdominal obesity are associated with cardiovascular risk factors, such as type 2 diabetes, hypertension, and dyslipidemia. Controversy remains regarding the best anthropometric indices for cardiovascular risk. Waist-to-height ratio has been reported to be an effective predictor of metabolic risks and it may be a better measure of relative fat distribution amongst subjects of different age and statures. Bangladeshi data lack in this perspective. To determine waist-to-height ratio of Bangladeshi adults along with its variation with socio-economic status, cross-sectional studies were conducted in 2002 and 2003. Data were collected through interviewing and measuring height and waist circumference of 22,995 adult males and females of an urban (Mirpur, Dhaka City) and rural area (Kaliganj sub-district). The mean waist-to-height ratio of 0.48 significantly varied with socio-demographic variables and it was markedly higher in females, older age groups, urban residents and the better educated. Urban residents, females, older people, better educational status, the non-paid and married individuals were more likely to have high waist-toheight ratio (≥0.5). High waist-to-height ratio levels using sex-specific cut-offs were more common in females, urban residents, Christians, older individuals, married, the better educated and the nonpaid. Age and locality were identified as best predictors in males and females, respectively. Key words: Waist-to-height ratio; adult; Bangladeshi DOI: 10.3329/imcj.v4i2.6496Ibrahim Med. Coll. J. 2010; 4(2): 49-58