High-intensity focused ultrasound (HIFU) is an increasingly popular treatment modality that is used for noninvasive body contouring. Several clinical studies have reported a significant reduction in subcutaneous adipose tissue after HIFU treatment, along with the histologic degradation of adipocytes and fat membranes. Similarly, preclinical studies have confirmed the safety and efficacy of HIFU and identified two mechanisms, namely heatinduced apoptosis and acoustic cavitation. Although the lipolytic effects of HIFU are well documented, insufficient research has been done on the metabolic changes caused by HIFU lipolysis yet. A recent metaanalysis of the outcome of non-invasive fat removal suggests that HIFU may positively lead to weight loss and wasit circumference reduction in the serum lipid profiles, potentially expanding its use from aesthetic to metabolic treatments. In conclusion, HIFU is emerging as an effective and safe tool for fat reduction via heatinduced apoptosis and acoustic cavitation and its use is expected to increase in body contouring. As more data emerges on its metabolic effects, HIFU may also find a place as adjunctive therapy for metabolic disorders.