Background: Prediabetes is a metabolic disorder characterized by higher serum glucose levels than normal and below the diagnostic threshold for diabetes mellitus. Afamin is a glycoprotein mainly excreted from the liver and facilitates vitamin E transport. Afamin is one of the albumin gene family that includes albumin, α-Fetoprotein, and vitamin D-binding protein. Aim: This study aimed to evaluate serum afamin levels in prediabetic individuals and ascertain the association of serum afamin with insulin resistance and glycemic indices. Material and Methods: A case-control study was performed at Azadi Teaching Hospital, Kurdistan Region, Iraq, consisted of 88 participants, 44 prediabetic individuals and 44 apparently healthy individuals as a control group. Prediabetic individuals were obtained from relatives of patients with diabetes mellitus visiting Azadi Teaching Hospital, whereas, healthy individuals were chosen from the medical staff and college employees. The diagnosis of prediabetes was made according to the American Diabetes Association criteria. Serum afamin were assessed by Enzyme-Linked Immunosorbent Assay, while other biochemical parameters such as HbA1c, glucose and insulin were analyzed by Cobas 6000 (Roche, Hitachi/ Germany). Results: Mean level of serum afamin was higher in prediabetic individuals (115.31±62.74) compared to their level in the control group (91.57±43.46), with a statistically significant difference (p = 0.042). The mean age of prediabetics was (44.05±10.56) with males predominant (63.6%) and 70.5% of them were more than 40 years and 88.6% were obese. Conclusion: The study concluded the presence of higher mean serum afamin levels among prediabetic individuals compared to the healthy control.