Abstract Background/aim: Central obesity (CO) confers a great threat on the cardio-metabolic health of the population. Central obesity is directly matched with increased visceral abdominal fat, and it is also matched with endothelial dysfunction, insulin resistance, hypercholesterolemia, and cancer. Purpose of the study: This study was designed to compare between the effect of ultrasound cavitation and phosphatidylcholine iontophoresis on central obesity in hypertensive women. Material and methods: It is a randomized controlled trial performed on 40 hypertensive centrally obese females divided into two equal groups. Group (A) consisted of 20 females received ultrasound cavitation, and Group (B) consisted of 20 females received phosphatidylcholine iontophoresis. The primary outcome measures were waist circumference, visceral fat range, systolic and diastolic blood pressure. Results: the results showed that there was a statistically significant improvement in central obesity and hypertension in Group A, but there was a statistically significant improvement in central obesity. Still, non-significant improvement in hypertension in Group B. Improvement in Group A is more significant than in Group B regarding the percent of the decline in WC, VFR, and DBP. Conclusion: there was an improvement in central obesity and blood pressure in women after applying ultrasound cavitation and phosphatidylcholine iontophoresis , with better results in ultrasound cavitation than phosphatidylcholine iontophoresis.