OBJECTIVE: To assess whether abdominal adiposity in early pregnancy is associated with a higher risk of glucose intolerance at a later gestational stage. RESEARCH DESIGN AND METHODS: Subcutaneous and visceral fat was measured with ultrasonography at approximately 12 weeks' gestation. A 50-g glucose challenge test (GCT) was performed between 24 and 28 weeks' gestation. The risk of having a positive GCT (>or=7.8 mmol/l) was determined in association with subcutaneous and visceral adipose tissue depths above their respective upper-quartile values relative to their bottom three quartile values. RESULTS: Sixty-two women underwent GCTs. A visceral adipose tissue depth above the upper quartile value was significantly associated with a positive GCT in later pregnancy (adjusted odds ratio 16.9 [95% CI 1.5-194.6]). No associations were seen for subcutaneous adipose tissue. CONCLUSIONS: Measurement of visceral adipose tissue depth in early pregnancy may be associated with glucose intolerance later in pregnancy.