Background:–Diagnosing pre–diabetes has been a challenging task and till date it is done on the basis of levels of plasma glucose and glycated hemoglobin(HbA1c).Fetuin–Acan serve as an important marker for dianosing pre–diabetes.The present study was designed to evaluate the role of Fetuin–A levels in predicting glycaemic outcome in people with pre–diabetes. Methods and Materials:The present cross sectional study was carried out in Department Of Biochemistry at People’s College of Medical Sciences & Research Centre, Bhopal. A total of 300 subjects were included, outof which 100 were known type2 diabetics, 100were pre–diabetics and 100were normal healthy individuals. Laboratory investigations included serum fasting and 2–hour glucose, HbA1c, insulin and Fetuin–A.Insulin resistance was calculated by Homeostatic model assesment(HOMA–IR). Results: We observed that serum Fetuin–A levels,insulin and HOMA–IR were significantly higher in known type 2 diabetics as compared topre–diabeticsand controls. Conclusion:Increased Fetuin A levels had an adverse impact on glycemic outcomesin pre–diabetesthus suggesting that Fetuin A can be used as a tool to determine the susceptibility of an individual to develop pre–diabetes and thus diabetes mellitus.