Acne vulgaris (AV) is a common multifactorial chronic inflammatory skin disease which is often associated with metabolic and hormonal factors. Our aim was to detect the level of serum apelin-12 in acne cases and to assess its correlation with body mass index (BMI), insulin resistance (IR) and acne severity. Ninety individuals were included in this case-control study, comprising 60 acne patients and 30 age-and sex-matched healthy controls. Clinical evaluation included BMI, waist circumference, and evaluation of the severity of acne by using the Global Acne Grading Scale (GAGS). Laboratory tests included serum apelin-12, serum fasting blood glucose (FBG), fasting insulin, and complete lipid profile (cholesterol, triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). IR was assessed by using Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR).