An absorbent article includes a front waist region, a back waist region and a crotch region interconnecting the front and back waist regions. An article fastening system attaches the back waist region to the front waist region to define a wear configuration of the absorbent article having a waist opening and a pair of leg openings. The waist opening has a size in the wear configuration of the article. A waist adjustment system includes a tab having an attachment region for attaching the tab to one of the front waist region and the back waist region and a tab region extending transversely outward from the attachment region. The tab region has a fastener region releasably attachable to multiple locations on the one of the front waist region and the back waist region to selectively alter the size of the waist opening in the wear configuration of the article.