Methylmalonic acid (MMA), a functional indicator of vitamin B12 insufficiency, was measured in the U.S. population in the National Health and Nutrition Examination Survey (NHANES) from 1999–2004 using a GC/MS procedure that required 275 µL of sample and had a low throughput (36 samples/run). Our objective was to introduce a more efficient, yet highly accurate LC-MS/MS method for NHANES 2011–2014. We adapted the sample preparation with some modifications from a published isotope-dilution LC-MS/MS procedure. The procedure utilized liquid-liquid extraction and generation of MMA di-butyl ester. Reversed-phase chromatography with isocratic elution allowed baseline resolution of MMA from its naturally occurring structural isomer succinic acid within 4.5 min. Our new method afforded an increased throughput (≤160 samples/run) and measured serum MMA with high sensitivity (LOD = 22.1 nmol/L) in only 75 µL of sample. Mean (±SD) recovery of MMA spiked into serum (2 days, 4 levels, 2 replicates each) was 94±5.5%. Total imprecision (41 days, 2 replicates each) for three serum quality control pools was 4.9–7.9% (97.1–548 nmol/L). The LC-MS/MS method showed excellent correlation (n=326, r=0.99) and no bias (Deming regression, Bland-Altman analysis) compared to the previous GC/MS method. Both methods produced virtually identical mean (±SD) MMA concentrations [LC-MS/MS: 18.47±0.71 ng/mL (n=17), GC/MS: 18.18±0.67 ng/mL (n=11)] on a future plasma reference material compared to a GC/MS method procedure from the National Institute of Standards and Technology [18.41±0.70 ng/mL (n=15)]. No adjustment will be necessary to compare previous (1999–2004) to future (2011–2014) NHANES MMA data.