Introduction: Insulin resistance shown to be associated with and even precede cardiovascular diseases, diabetes mellitus and metabolic syndrome could be identified by cutaneous markers of insulin resistance namely, Acanthosois nigricans and Acrochordons. Objective: The aim was to assess the presence of cutaneous lesions and relate with Insulin resistance. Materials and methods: A total of 80 patients (40 cases and 40 controls) had their BMI, Waist Hip ratio (WHR), lipid profile, fasting glucose levels and fasting insulin levels checked, HOMA–IR was calculated and correlation between skin lesions and insulin resistance was evaluated. Results: The mean age of the participants was 44 years (range 20–70) with a female preponderance. The mean BMI in cases was 26.19 +4.1 and in controls 23.60 + 2.5. This shows the significant risk by odds ratio of 2.07 times. The mean WHR in cases showed the significant risk by odds ratio of 1.57 times. The mean total cholesterol value in cases with odds ratio of 1.13 and the mean LDL cholesterol value in cases with odds ratio of 1.76 showed a significant risk. The mean HOMA–IR values in cases with odds ratio of 1.58 showed that individuals with HOMA–IR more than 1.7 have 1.58 times risk of developing skin lesions i.e. Acanthosis and Acrochordons. Conclusion: This study shows a significant risk association between skin lesions and insulin resistance .