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Abstract: Objective: Central obesity is considered to be a central component of metabolic syndrome. Waist circumference (WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese. Methods: The study involved 923 subjects aged 40–65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85–90 cm and ≥90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80–85 cm and ≥85 cm were used as cut-off values of central pre-obesity and central obesity in females. Results: First, WC values corresponding to body mass index (BMI) 24 kg/m2 and visceral fat area (VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females (81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels. Conclusion: WC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors. [Copyright &y& Elsevier]