Obstructive sleep apnea (OSA) is associated with increased risk for cardio–metabolic dysfunction. Macrophage migration inhibitory factor (MIF) has been shown to play a key role in inflammation. We hypothesized that increase serum MIF levels and MIF variant frequencies may have associated with OSA and this may affect cardio–metabolic risk. 200 subjects, 100 with OSA and 100 without OSA were evaluated. Serum MIF levels was determined using ELISA. Sequencing was carried out to checkMIF–173 G/C gene polymorphism using Big Dye Terminator v3.1 Cycle Sequencing Kit on an ABI Genetic Analyzer 3730. Serum MIF levels were elevated in subject with OSA, it correlated with severity of OSA and this correlation was independent of age and obesity. MIF gene frequency of CC, GG and GC was 3%, 75% and 22% in subject with OSA, while it was 4%, 56% and 40% in subjects without OSA respectively. Serum MIF level are elevated and associated with severity of OSA. Up– regulation of MIF may play a role in the progression of cardio–metabolic risk. We recommend further studies to focus on MIF as a potential marker and screening tool for OSA.