Antioxidant micronutrients, such as vitamins and carotenoids, exist in abundance in fruits and vegetables and have been known to contribute to the body's defense against reactive oxygen species. Numerous recent epidemiologic studies have demonstrated that a high dietary consumption of fruit and vegetables rich in carotenoids or with high serum carotenoid concentrations results in lower risks of certain cancers, diabetes, and cardiovascular disease. These epidemiologic studies have suggested that antioxidant carotenoids may have a protective effect against several lifestyle-related diseases. β-Cryptoxanthin is a carotenoid pigment found in Japanese mandarin (Citrus unshiu MARC.) fruit, which is mainly produced in Japan. Our nutritional epidemiologic survey, the Mikkabi Study, utilized data derived from health examinations of inhabitants performed in the town of Mikkabi in Shizuoka, Japan. In this survey, we measured serum β-cryptoxanthin as a specific biomarker to estimate the consumption of Japanese mandarin fruit. From the cross-sectional analyses from the Mikkabi Study, we found inverse associations of serum β-cryptoxanthin with the risks for atherosclerosis, insulin resistance, liver dysfunction, metabolic syndrome, low bone mineral density, and oxidative stress. In this review, recent epidemiologic studies about the associations between serum β-cryptoxanthin with the risk for several lifestyle-related diseases were reviewed.