Background:　Visceral　obesity　(VO),　associated　with　excessive　visceral　adipose　tissue　(VAT),　has　been　extensively　studied　in　cancer.　However,　whether　low　VAT　can　predict　the　prognosis　of　colorectal　liver　metastases　(CRLM)　undergoing　neoadjuvant　chemotherapy　(NAC)　remains　unknown.　Methods:　This　multicentre　real-world　cohort　study　analysed　data　from　initially　resectable　CRLM　patients　who　received　NAC.　The　predictive　effect　of　VAT　on　progression-free　survival　(PFS)　and　overall　survival　(OS)　was　evaluated　using　restricted　cubic　splines　(RCS).　VAT　was　categorized　into　low/normal　VAT　and　VO　groups　using　X-tile.　The　prognostic　differences　were　further　assessed　through　Kaplan-Meier　(KM)　analysis.　The　impact　of　changes　in　VAT　(Delta　VAT)　after　NAC　was　evaluated.　Results:　Among　1524　CRLM　patients,　1105　patients　(72.51%)　were　under　65　years　old,　with　a　median　VAT　of　84.00　(36.24-148.00)　cm(2).　Of　all　patients,　804　(52.76%)　were　female.　A　U-shaped　nonlinear　relationship　was　observed　between　VAT　and　both　PFS/OS　(p　＜　0.001).　Compared　with　the　normal　VAT,　both　low　VAT　and　VO　groups　showed　worsened　PFS　and　OS　(p　＜　0.05).　The　3-year　PFS　rate　was　31.6%,　69.0%　and　42.0%　in　the　low,　normal　VAT　and　VO　groups　(p　＜　0.05).　The　3-year　OS　rate　was　76.4%,　88.9%　and　79.4%　in　the　low,　normal　VAT　and　VO　groups　(p　＜　0.05).　There　was　also　a　nonlinear　relationship　between　VAT　and　NAC-related　adverse　events,　objective　response　rate　and　postoperative　complications　(p　＜　0.001).　An　increase　in　Delta　VAT　in　the　low　VAT　group　was　associated　with　better　PFS　and　OS　(p　＜　0.05).　In　the　VO　group,　both　increases　and　decreases　in　Delta　VAT　were　associated　with　worsened　PFS　and　OS　(p　＜　0.05).　Conclusions:　This　study　is　the　first　to　reveal　that　low　VAT　and　VO　can　predict　PFS　and　OS　in　CRLM　patients　undergoing　NAC.　Baseline　VAT　and　Delta　VAT　may　serve　as　important　indicators　for　risk　stratification　and　personalized　treatment　in　CRLM　patients.