Abstract: Objective：To investigate the effect of abdominal obesity on sarcopenia and osteoporosis in elderly people with normal body mass index (BMI). Methods：From January 2018 to October 2018, 223 elderly patients (age＞60 years) with normal BMI were selected in the Department of Gerontology (General Medicine) in Jiangyin People’s Hospital. According to the visceral fat area (VFA), the patients were divided into abdominal obesity group (VFA>100 cm2, n=113) and non-abdominal obesity group (VFA≤100 cm2, n=110). The general situations and laboratory features such as BMI, blood pressure, fasting blood glucose, fasting insulin (FINS), VFA value, walking speed, grip strength, appendicular skeletal muscle mass index (ASMI), and bone mineral density (BMD) were measured, the differences between the two groups were compared by t test and chi-square test. The correlation between the VFA and sarcopenia and osteoporosis were analyzed using Pearson analysis. Results：The differences in VFA, ASMI, and lumbar BMD between the abdominal group and the non-abdominal group were statistically significant (P<0.05). The incidence of sarcopenia, osteoporosis, and sarcopenia combined with osteoporosis were higher in the abdominal group than those in the non-abdominal group (P<0.05). The differences of ASMI and BMD in the severe group (VFA≥120 cm2), moderate group (110 cm2≤VFA＜120 cm2), and the mild group (100 cm2≤VFA＜110 cm2) were statistically significant in the elderly with abdominal obesity (P<0.05). Pearson correlation analysis showed that VFA was negatively correlated with lumber BMD (r=-0.416) and ASMI (r=-0.436) in the elderly with abdominal obesity and normal BMI (P<0.05). Conclusions：Even with a normal BMI, abdominal obesity would increase the risk of sarcopenia and osteoporosis in the elderly. The higher VFA, the more severe the sarcopenia and osteoporosis will be in the elderly. Strengthening visceral obesity screening in the elderly is of great significance to prevent the occurrence of sarcopenia and osteoporosis.