The incidence of prostate cancer has gradually increased with obesity in Korean males. We aimed to quantify visceral fat content measured by magnetic resonance imaging (MRI) as a risk factor of prostate cancer. This
case-control study that included 100 patients (mean age, 66.1 ± 7.1 years) newly diagnosed with prostate cancer and 100 healthy males (mean age, 63.4 ± 4.6 years) without cancer. All subjects underwent 3.0 Tesla MRI. Prostate cancer patients had a significantly higher abdominal fat ratio (p < 0.04) and regression for prevalence (β = 0.52, p < 0.01), other than obesity factors (waist circumference and body mass index), than the controls. In prostate cancer patients, a higher abdominal fat ratio was associated with a higher Gleason score level using odds ratios but excluding other obesity factors. Abdominal fat ratio is a risk factor of prostate cancer and clinical stage.