Objective: Visceral adipose tissue (VAT) and hepatic fat deposition are the most important risk factors for women's health. Acupuncture, including electroacupuncture (EA), is used to treat obesity throughout the world. The effect of EA is evaluated mainly by body mass index (BMI) and waist circumference (WC). Few studies have assessed its effect in reducing VAT volume and hepatic fat fraction (HFF) based on an exact measurement method such as magnetic resonance imaging (MRI). This study aimed to resolve this issue. Methods: Thirty subjects were randomly divided into two groups. The control group (n=15) did not receive any intervention and maintained a normal diet and their usual exercise habits. The treatment group (n=15) received EA three times a week for 3 months. BMI and WC were measured using different devices. VAT and HFF were measured by MRI and calculated by related software before and after the intervention. Results: A marked difference was evident in group that received EA treatment in the following tests. The differences in BMI (U=21.00, p<0.001), WC (U=40.50, p=0.002), VAT volume (U=13.00, p<0.001), and mean HFF (U=0.00, p<0.001) before and after the intervention in the treatment group were distinct and significant compared with those of the control group. Three months later, the treatment group showed a lower BMI (W=91.00, p=0.001), WC (t=4.755, p<0.001), VAT volume (t=5.164, p<0.001), and mean HFF (W=120.00, p=0.001) compared with pretreatment levels. Compared with the control group, the treatment group showed a lower VAT volume (t=60.00, p=0.029) after 3 months of treatment. After 3 months, the control group showed higher mean HFF (t=-2.900, p=0.012) and VAT volume (W=11.50, p=0.006) compared with their initial levels. Conclusion: Based on MRI evaluation, this randomized controlled study proved that EA treatment reduces BMI and WC as well as VAT volume and HFF in women with abdominal obesity.