Aims. This study was to evaluate the association of serum vaspin concentrations with body mass index (BMI) among elderly patients (>60 years old). Methods. A total of 227 elderly individuals included 76 healthy with normal glucose tolerance, which divided into normal weight control (BMI < 25, n = 38) and overweight or obese control (BMI ≥ 25, n = 38) subgroups, and 150 T2DM patients, which divided into normal weight diabetes (BMI < 25, n = 55), overweight diabetes (30 > BMI ≥ 25, n = 52), and obese diabetes (BMI ≥ 30, n = 43) subgroups. Relevant parameters were matched for age and gender ratio. Serum vaspin concentrations were measured by enzyme-linked immunosorbent assay. Results. Serum vaspin concentration was significantly higher in the T2DM than the healthy (451.9 ± 32.6 versus 284.2 ± 21.7, P < 0.01). In the diabetic patients, the vaspin concentration was significantly higher in the obese group than the normal weight group (498.2 ± 17.1 versus 382.1 ± 21.3, P < 0.05). In addition, the concentration of vaspin in normal weight T2DM was higher than in healthy control group with normal weight (382.1 ± 21.3 versus 192.5 ± 45.2, P < 0.05). Multiple regression analysis revealed that BMI was independent factors influencing the serum vaspin concentration in all participants. Conclusion. Vaspin may play an important compensatory role in obesity and insulin resistance in elderly people. The clinical trial registration number is ChiCTR-OPC-14005698.