This study investigated the association between changes in neck circumference (NC) and visceral fat area (VFA) in a Chinese community-based longitudinal cohort. After a mean follow-up of 2.1 years, individuals with a >5% NC increase had 1.26 times more visceral adipose tissue than those with stable NC. Changes in NC were also significantly associated with abdominal obesity in individuals without baseline abdominal obesity. These findings suggest that NC measurement could be a practical tool for assessing abdominal obesity.