Background: The medicinal use of vinegar dates to ancient times, and empirical evidence has mounted over the past several decades supporting health benefits from vinegar ingestion, including reductions in blood glucose, blood pressure, and blood cholesterol. Additionally, although clinical trial data are mixed, there are several reports demonstrating reductions in body mass and fat mass with daily vinegar ingestion. This blinded, randomized controlled trial examined the impact of daily vinegar ingestion on anthropometric measures in healthy young adults recruited from a campus population. Methods: Participants (n = 28; aged 25.8 ± 7.0 years; body mass index BMI >23 kg/m2) were stratified by age, sex, and BMI and randomly assigned to the liquid VIN or pill CON groups. VIN participants diluted 2 tablespoons of red wine vinegar (750 mg acetic acid; Pompeian Inc.) in 8-12 ounces of water to drink with food at meal-time twice daily. CON participants consumed 1 vinegar pill daily (30 mg acetic acid; Walmart's Spring Valley brand). All participants provided written consent for this IRB approved trial. The study lasted 4 weeks, and anthropometric measurements were conducted in a fasted state at weeks 0 and 4. Study adherence varied slightly (90 ± 17% and 100 ± 14% for VIN and CON respectively, p = 0.084); hence, adherence was controlled for in all analyses. Results: Changes in BMI (-0.1 ± 0.5 and + 0.1 ± 0.3 kg/m2, p = 0.127) and body weight (-0.3 ± 1.4 and + 0.1 ± 1.1 kg, p = 0.158) did not differ significantly between VIN and CON groups respectively. However, both waist circumference and percent body fat were reduced significantly for VIN participants in comparison to CON participants (-0.5 ± 1.3 vs. +0.7 ± 2.4 cm p = 0.026 and -0.4 ± 0.7 vs. +0.3 ± 1.0% p = 0.045). Conclusions: Although the observed differences between groups are modest, the study was short of duration and did not apply energy restriction or exercise interventions, suggesting a possible benefit of vinegar ingestion on adiposity.