Background Tumor necrosis factor-α (TNF-α) is an inflammatory cytokine involved in atherogenesis. Adipose tissue is an important source of endogenous TNF-α production. Pioglitazone, a member of the thiazolidinediones (TZDs), has anti-inflammatory and anti-atherogenic properties, while underlying mechanism has not been fully elucidated. The aim of this study was to evaluate the effect of pioglitazone on TNF-α serum concentration and mRNA expressions of subcutaneous adipose tissue in hypercholesterolemic rabbits. Methods Ten rabbits fed with high-cholesterol diet for 8 weeks were randomly divided into two groups: (1) high cholesterol group (n = 5): maintained high cholesterol diet for 4 weeks; (2) pioglitazone group (n = 5): the same cholesterol diet plus pioglitazone (3 mg/kg/day) for 4 weeks. Control group (n = 5) was fed with normal diet for 12 weeks. Subcutaneous adipose tissue was collected for RNA analysis. The direct effect of pioglitazone on TNF-α release was assayed in primary rabbit adipocytes. TNF-α levels in serum and adipocytes culture supernatant were measured by ELISA. RT-PCR was used to evaluate TNF-α mRNA expressions in adipose tissue and adipocytes. Results Compared with control group, rabbits fed with high cholesterol diet showed significantly higher levels of serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and TNF-α. Though having no effect on serum glucose level and lipid profile, pioglitazone administration significantly reduced circulating TNF-α concentrations, which were positively correlated with TNF-α mRNA expressions of adipose tissue (r = 0.53, P < 0.01). Pioglitazone dose-dependently inhibited lipopolysaccharide (LPS)-induced TNF-α secretion and mRNA expression in cultured adipocytes. Conclusion Pioglitazone significantly reduced serum TNF-α level in hypercholesterolemic rabbits independent of its metabolic actions, which may at least partly be due to its direct inhibition of TNF-α expression and secretion of adipocytes. This may help to explain the mechanism by which pioglitazone exert anti-atherosclerotic effects.