Obesity is a heterogeneous condition and risk of related health outcomes in different obesity phenotypes is a controversial subject. In this study, we aimed to evaluate the risk of cardiovascular disease (CVD) and all-cause mortality in different abdominal obesity phenotypes during a decade-long follow-up. In this large population-based cohort, 7122 participants (42.7% men), aged 30 years, from the Tehran Lipid and Glucose Study (TLGS) were enrolled. MHAO was defined as abdominal obesity (waist circumference 91cm for women and 89 cm for men) with healthy metabolic profile with less than 2 criteria from joint interim statement (waist not included). Then, all-cause mortality risk and CVD, adjusted for age and sex were estimated using Cox proportional hazards models.