This editorial discusses the history, definition and prevelance of the metabolic syndrome. Pathophysiological factors, such as girth, blood pressure, glucose, triglycerides, HDL-cholesterol, obesity, raised levels of plasma insulin and insulin resistance are outlined as being components of the syndrome. The paper examines the relationship of cardiovascular and all-cause mortality to the metabolic syndrome, and discusses the risk of cardiovascular disease associated with the metabolic syndrome. In addition, the article explores the link between metabolic syndrome, kidney function, insulin resistance and chronic kidney disease. Finally, the article discusses the issue of managing metabolic syndrome.