Objectives: The aim of this study was to use magnetic resonance imaging (MRI) together with proton magnetic resonance spectroscopy (H-1-MRS) to study the influence of acupuncture therapy on abdominal fat and hepatic fat content in obese children. Design: The design was a longitudinal, clinical intervention study of acupuncture therapy. Subjects: Subjects were 10 healthy, obese children (age: 11.4 +/- 1.65 years, body-mass index [BMI]: 29.03 +/- 4.81 kg/m(2)). Measurements: Measurements included various anthropometric parameters, abdominal fat (assessed by MRI) and hepatic fat content (assessed by H-1-MRS) at baseline and after 1 month of acupuncture therapy. Results: One (1) month of acupuncture therapy significantly reduced the subjects' BMI by 3.5% (p = 0.005), abdominal visceral adipose tissue (VAT) volume by 16.04% (p < 0.0001), abdominal total adipose tissue volume by 10.45% (p - 0.001), and abdominal visceral to subcutaneous fat ratio by 10.59% (p - 0.007). Decreases in body weight (-2.13%), waist circumference (-1.44%), hip circumference (-0.33%), waist-to-hip ratio (WHR) (-0.99%), abdominal subcutaneous adipose tissue (SAT) volume (-5.63%), and intrahepatic triglyceride (IHTG) content (-9.03%) were also observed, although these were not significant (p > 0.05). There was a significant correlation between the level of abdominal fat (SAT, VAT) and anthropometric parameters (weight, BMI, waist circumferences, hip circumferences). There was no statistically significant correlation between IHTG and anthropometric parameters or abdominal fat content. Conclusions: The first direct experimental evidence is provided demonstrating that acupuncture therapy significantly reduces BMI and abdominal adipose tissue by reducing abdominal VAT content without significant changes in body weight, waist circumference, hip circumference, WHR, abdominal SAT, or IHTG content. Thus, the use of acupuncture therapy to selectively target a reduction in abdominal VAT content should become more important and more popular in the future.