Objective: To evaluate the efficacy of the "double-low" scanning protocol combined with the artificial intelligence iterative reconstruction (AIIR) algorithm for abdominal computed tomography (CT) enhancement in obese patients and to identify the optimal AIIR algorithm level. Methods: Patients with a body mass index >= 30.00 kg/m(2) who underwent abdominal CT enhancement were randomly assigned to groups A or B. Group A underwent conventional protocol with the Karl 3D iterative reconstruction algorithm at levels 3-5. Group B underwent the "double-low" protocol with AIIR algorithm at levels 1-5. Radiation dose, total iodine intake, along with subjective and objective image quality were recorded. The optimal reconstruction levels for arterial-phase and portal-venous-phase images were identified. Comparisons were made in terms of radiation dose, iodine intake, and image quality. Results: Overall, 150 patients with obesity were collected, and each group consisted of 75 cases. Karl 3D level 5 was the optimal algorithm level for group A, while AIIR level 4 was the optimal algorithm level for group B. AIIR level 4 images in group B exhibited significantly superior subjective and objective image quality than those in Karl 3D level 5 images in group A (P < 0.001). Group B showed reductions in mean CT dose index values, dose-length product, size-specific dose estimate based on water-equivalent diameter, and total iodine intake, compared with group A (P < 0.001). Conclusion: The "double-low" scanning protocol combined with the AIIR algorithm significantly reduces radiation dose and iodine intake during abdominal CT enhancement in obese patients. AIIR level 4 is the optimal reconstruction level for arterial-phase and portal-venous-phase in this patient population.