Objective：To investigate the relationship between serum uric acid and insulin sensitivity in pre-diabetic patients through hyperinsulinemic-euglycemic clamp. Methods：A total of 108 pre-diabetic subjects were included in the study. The subjects were divided into normal glucose regulation（NGR） group（66 cases）and impaired glucose regulation（IGR） group（42 cases）according to the diagnostic criteria in 2011 American Diabetes Association. Uric acid and other biochemical markers were measured from fasting blood sample. All the patients underwent hyperinsulinemic-euglycemic clamp，and glucose infusion rate（GIR）was calculated to assess insulin sensitivity. Results：Compared with NGR patients，IGR patients had higher levels of BMI，WC，TG，TC，FINS，CP，SUA and lower levels of HDL-C and GIR（P < 0.05）. GIR was negatively correlated to BMI，WC，SUA（P < 0.05）in IGR patients. GIR was gradually and significantly decreased with increase of serum SUA level. Logistic regression analysis showed that serum SUA was a risk factor for insulin resistance［OR=1.008，95％CI：1.004~1.013，P＜0.001］. Conclusion：In the pre-diabetic patients，there is a negative correlation between serum uric acid and insulin sensitivity. The higher serum uric acid is，the lower insulin sensitivity is.