This meta-analysis on the relation between total adiponectin levels and risk of type 2 diabetes included 13 prospective studies with a total of 14 598 participants and 2623 incident cases. Overall, higher adiponectin levels were associated in a dose-response relationship with a lower risk of type 2 diabetes in several populations (Whites, East Asians, Asian Indians, African Americans and Native Americans) and were not influenced by adiponectin assay, method of diabetes ascertainment and duration of follow-up. The relative risk of type 2 diabetes was 0.72 (95% CI, 0.67 – 0.78) per 1-log ug/ml increment in total adiponectin levels. Thus, adiponectin is a strong predictor of type 2 diabetes and possibly a promising target to reduce risk of type 2 diabetes.