To identify the anthropometric index that best detects cardiovascular risk (CVR) and type 2 diabetes (DM2) in the adult Spanish population and to determine its cut-off point. Cross-sectional study in the general population (n=6279). Sensitivity and specificity were estimated for the anthropometric indexes: abdominal waist, body mass index, waist to hip ratio and waist to height ratio (WtHR). The areas of these indexes under ROC curve (AUC) were obtained for the following CVR factors: high coronary risk computed with Framingham model, Hypertension, Hyperlipemia, DM2, Metabolic Syndrome (MS) and Impaired Fasting Glucose (IFG). The odds ratio, with 95% confidence interval (CI(95%)), was calculated. WtHR was the index showing the highest AUC for DM2 and the remaining CVR factors, varying between 0.65 (CI(95%)=0.63-0.68) for IFG in men and 0.87 (CI(95%)=0.86-0.89) for MS in women. RA/E reached the maximum sensitivity (0.91) and specificity (0.70) in SM and its optimal cut-off point was 0.55, which displayed the highest risks amongst indexes, varying from 2.30 (1.96-2.70) in IFG to 16'20 (13.68-19.20) in MS. RA/E is the index presenting the best ability to detect DM2 and CVR in this population, and it shows the stronger association with them. Its cut-off point, 0.55, confirms the convenience of keeping the abdominal waist to less than half the height.