The aim of this study was to elaborate a new sex-specific index to estimate the visceral adiposity dysfunction associated with cardiometabolic risk. The visceral adiposity index (VAI) was based on waist circumference, body mass index, triglycerides and HDL cholesterol levels. It was also modeled on 315 nonobese healthy subjects and validated in 1,498 primary care patients using two multiple logistic regression models to explore possible determinants of cardiovascular and cerebrovascular events. VAI was significantly correlated to metabolic syndrome clinical variables. VAI was independently associated to cardiovascular events, along with age at the time of event, smoking and male sex. Moreover, VAI and age at the time of event were the only independent risk factors for cerebrovascular events. VAI was also inversely associated with insulin sensitivity. These results suggest that VAI might be a useful tool to evaluate the cardiometabolic risk associated with intra-abdominal (visceral) obesity.