Objective: To evaluate the influence of acupuncture therapy on abdominal fat and hepatic fat content in obese children with magnetic resonance imaging (MRI) together with proton magnetic resonance spectroscopy ( 1 H-MRS). Methods: Ten obese children (seven boys and three girls) were recruited. The body weights, body mass index (BMI), waist circumferences, hip circumferences, waist-to-hip ratios (WHR), abdominal fat volume (assessed by MRI) and hepatic fat content (assessed by 1 H-MRS) were measured before and after 1 month of regularly acupuncture therapy. Results: BMIs reduced by 3.50% after 1 month of acupuncture therapy (P=0.005). Abdominal visceral adipose tissue (VAT) volume, abdominal total adipose tissue (TAT) volume and abdominal visceral to subcutaneous fat ratio (V/S) all decreased after therapy (P<0.05). Decreases in body weight, waist circumference, hip circumference, WHR, abdominal subcutaneous adipose tissue (SAT) volume and intrahepatic content of lipid (IHCL) were also observed, but no statistical difference was found (P>0.05). Before and after acupuncture therapy, there was a significant correlation between the level of abdominal fat volume (SAT, VAT) and anthropometric parameters (weight, BMI, waist circumferences, hip circumferences). There was no statistically significant correlation of IHCL with anthropometric parameters and abdominal fat volume. Conclusion: Acupuncture therapy can significantly reduce BMI and abdominal adipose tissue volume through reducing abdominal VAT content in obese children.