The aim of this study is to analyze the relationships between obesity, fat distribution and pharyngeal transversal area in women. Cross-sectional areas of the pharynx at the oro-pharyngeal junction and at the glottis and mean pharyngeal area were measured by acoustic pharyngometry in 145 women (age 42.9 +/- 15.1 years; range 14-82 years). Body weight, waist, hip and neck circumferences, and sagittal abdominal diameter (SAD) were determined. Pharyngeal area at the oro-pharyngeal junction, measured both in orthostatic and in lying position, was negatively related to BMI, waist, hip and SAD. Mean pharyngeal area was negatively related to BMI and to SAD only in orthostatic position. No significant correlations were found between pharyngeal areas at the glottis and any anthropometric measurements. In multiple regression analysis, only SAD retained independent relationship with pharyngeal area at the level of the oro-pharyngeal junction in both the positions and with mean pharyngeal area in the orthostatic position. We demonstrated an inverse association between upper airways size and both adiposity and visceral fat distribution in women.