To elucidate the underlying mechanism behind the thermogenic effect of adrenaline in human skeletal muscle, nine healthy subjects were studied during intravenous infusion of adrenaline. Restriction of blood flow to one forearm was obtained by external compression of the brachial artery, to separate a direct metabolic effect of adrenaline from an effect dependent on increased blood flow. The other arm served as the control arm. In the control arm, the forearm blood flow increased 4.7-fold (from 2.0 ± 0.3 to 9.3 ± 1.5 mL 100 g−1 min−1, P < 0.001) during the adrenaline infusion. Adrenaline significantly increased forearm oxygen consumption (from 4.7 ± 2.1 to 7.0 ± 3.6 μmol 100 g−1 min−1, P < 0.025). In the arm with restricted blood flow, the forearm blood flow increased 2.9-fold (from 1.6 ± 0.3 to 4.6 ± 0.8 mL 100 g−1 min−1, P < 0.002) but the forearm oxygen consumption did not increase (baseline period: 5.6 ± 2.3 μmol 100 g−1 min−1, adrenaline period: 6.1 ± 2.1 μmol 100 g−1 min−1, P = 0.54). The experimental design and the difficulties in interpretation of the result are discussed. The results give evidence for the hypothesis that the vascular system plays a key role in the thermogenic effect of adrenaline in skeletal muscle in vivo.