Fatty acids (FA) are important substrates for brown adipose tissue (BAT) metabolism, however, it remains unclear whether there exists a difference in FA metabolism of BAT between lean and obese healthy humans. In this study we evaluated supraclavicular BAT fatty acid uptake (FAU) along with blood perfusion in lean and obese subjects during cold exposure and at room temperature using positron emission tomography (PET)/computed tomography (CT). Additionally, tissue samples were taken from supraclavicular region (typical BAT region) from a subset of subjects to evaluate histological presence of BAT. Non-shivering cold stress elevated FAU and perfusion of BAT in lean, but not in obese subjects. Lean subjects had greater FAU in BAT compared to obese subjects during cold exposure and interestingly also at room temperature. The higher BAT FAU was related to younger age and several indicators of superior systemic metabolic health. The subjects who manifested BAT histologically had several folds higher BAT FAU compared to subjects with no such histological manifestation. Together, obese subjects have less active tissue in supraclavicular region both in basal and cold-activated state and the FA metabolism of BAT is blunted in obesity. Brown adipose tissue (BAT) is specialized in producing heat. For thermogenesis it utilizes intracellular stored triglycerides as well as circulating free fatty acids (FFA) and glucose 1. The cold stress elevates BAT metabolism for UCP-1 mediated thermogenesis effectively: the tissue is activated to maintain body temperature without muscle shivering known as non-shivering thermogenesis (NST) 2. In human studies where accumulation of radiolabeled glucose analogue 18 F-2-fluoro-2-deoxy-d-glucose (18 F-FDG) has been used as a marker of thermogenesis, it was shown that BAT glucose uptake increases in cold conditions 3-5. In addition to higher glucose uptake, the blood perfusion of BAT has found to be increased in response to cold exposure 3,6. BAT is also considered to have role in the energy balance of adult humans; it has been shown that cold-induced blood flow and glucose uptake are remarkably lower in obese subjects than in lean subjects 7,8. While glucose metabolism of BAT has been more widely studied, the role of fatty acids in human BAT metabolism is not yet clear. In rodents BAT relies on fatty acids up to 90% over glucose to generate heat 1. The primary source of fatty acids for oxidation in BAT is thought to be the intracellular lipid pool 1,9,10. If the fatty acids derived from intracellular stores are not available, circulatory glucose and free fatty acids derived from white adipose tissue lipolysis become important sources of energy for BAT 11,12. It has been shown that the thermogenic capacity of human BAT is reduced when intracellular triglyceride lipolysis is suppressed, supporting the role intracellular lipids have in BAT function 9. Circulatory fatty acid uptake (FAU) of BAT has been studied with positron emission tomography (PET) imaging using 14(R,S)-18 F-fluoro-6-thia-heptadec...