White adipose tissue vasculature constitutes 6% of tissue volume, and the normal flow is approximately 3–15 ml/min x 100 g. The blood perfusion is regionally heterogeneous, and also varies between individuals. The blood flow regulation through white adipose tissue is complex and is modulated by local metabolism, endothelium-derived factors, the nervous system as well as locally and systemically produced adipokines. The development of adipose tissue and its vasculature is angiogenesis dependent, and inhibition of the latter decreases adipose tissue growth. Disturbances in structure of adipose tissue vasculature and blood flow regulation are seen in e.g. obesity and type 2 diabetes mellitus. In this respect, adipose tissue vasculature is similar to that of pancreatic islets. It has been suggested that rarefication of the blood vessels and decreased blood perfusion causes hypoxia in adipose tissue in obesity, which contributes to dysregulation of adipose tissue by stimulating the inflammatory response of macrophages and release of inflammation-related adipokines. The latter can also induce a more general vascular dysfunction in the body. A clarification of the mechanisms behind white adipose tissue microcirculation will be of importance to address vascular dysfunction in both obesity and type 2 diabetes mellitus.