Background: The rising prevalence of cardio–metabolic risk factors like hypertension, diabetes, dyslipidemia and obesity significantly contributes to the rise in individuals with metabolic syndrome (MetS).1Interestingly, thyroid abnormalities like subclinical or overt hypothyroidism have been reported with a greater frequency in patients with MetS than general population.2Metabolic syndrome is clustering of various parameters which enhance the vulnerability of an individual to cardiovascular disorders. Previous studies suggested thatthyroid dysfunction, mainly hypothyroidism was prevalent among 35.2% of MetS patients.3.Alternatively, patients with thyroid dysfunction also found to have increased frequency of MetS. The consequences of untreated hypothyroidism can be additionally detrimental for cardiovascular health of anindividual who already has the MetS. Hence to assess the burden of thyroid dysfunction in patients of MetS, the present study was undertaken. Methods: This cross–sectional observational study was conducted in tertiary hospital on 100 subjects with metabolic syndrome. Results: Mean age of study subjects with MetS was 55.9±10.7 years. MetS was found in the age group of 51–60 yrs in most of the patients. We studied 54% males& 46% females. We observed that 60% subjects were euthyroid and thyroid dysfunction was seen in remaining 40% subjects. Among these, 38% were hypothyroid and 2% were hyperthyroid. Further, subclinical and overt hypothyroidism was seen in 12% and 26% subjects respectively. Mean WC in our subjects was 97.7±9.4 cm and it ranged from 62 to 139 cm. When defined by BMI, obesity was seen in 78% cases as per the criteria for South Asian population. Among various components of MetS, dyslipidemia (96%) was most frequent and obesity (57%) was least common. The diabetes was newly detectedin33.6% and hypertension in 27.1% patients for first time. In MetS subjects, obesity was found to be significantly associated with hypothyroidism than euthyroidism (71.1% vs 48.3%, p=0.027). Similarly, hypertension showed significant association with hypothyroidism compared to euthyroid subjects (94.7% vs 78.3%, p=0.028). No significant association with diabetes (p=0.933) or dyslipidemia (p=0.129) was seen. Overall, distribution of various MetS components did not differ significantly in patients with subclinical and overt hypothyroidism. In two subjects of hyperthyroidism, association with all components of MetS except obesity was seen. Conclusion: The thyroid dysfunction in form of hypothyroidism is found to be common in subjects of MetS.It is evident that there is strong association of certain MetS components like obesity & hypertension with hypothyroidism. This necessitates that all patients with MetS should be screened for thyroid dysfunction so that the impact of various metabolic consequences of this dysfunction can be ameliorated by judicious treatment in time. It will improve the cardio–metabolic profile and therefore long term outcome of such patients.