Background Visceral obesity (VATob) increases the risk for many diseases. Central obesity has been associated with an augmented prescription use; however, there is a paucity of research focused on VATob. Here, the aim was to evaluate the association between VATob and prescription use. Methods Data was collected from the NHANES dataset (2011-2018). Visceral adipose tissue was measured using dual x-ray absorptiometry, and VATob was defined as >= 100 cm2. Prescription use was collected from the RXQ_RX files and classified according to Vademecum. Association between VATob and prescription use was determined with logistic regression and reported as odds ratios (ORs) with 95% confidence intervals (95%CIs). Results 10,952 participants (weighted: 121,090,702) were included, in which 41.8% were VATob and 52.0% of them had >= 1 prescription. Overall, VATob demonstrated an augmented rate of prescription use when compared to non-VATob (52.0% versus 36.7%, p<0.001), specifically with metabolic (4.5-fold increase), cardiovascular (3.9-fold increase), gastrointestinal (2.5-fold increase), and hematopoietic agents (2.3-fold increase). This was associated with increased the risk for overall prescription use (ORoverall = 1.9, 95%CI: 1.7-2.1, p<0.001). Similar results were observed with metabolic and cardiovascular agents. However, when stratified by BMI, normal weight participants (ORmetabolic = 10.4; 95%CI: 6.5-16.6 & ORcardiovascular = 7.0; 95%CI: 4.4-11.1, p<0.001) had a greater risk than the overweight (ORmetabolic = 4.1; 95%CI: 3.0-5.6 & ORcardiovascular = 3.4; 95%CI: 2.5-4.7, p<0.001) or obese participants (ORmetabolic = 3.5; 95%CI: 2.3-5.3 & ORcardiovascular = 3.5; 95%CI: 2.5-4.9, p<0.001). Conclusion VATob is associated with augmented prescription use, particularly with cardiovascular and metabolic agents. This association was higher for normal weight participants.