A comprehensive review on metabolic syndrome (MetS) highlights its role as a major public health challenge, characterized by a cluster of interconnected physiological, biochemical, clinical, and metabolic factors that increase the risk of cardiovascular disease, type 2 diabetes mellitus (T2DM), and all-cause mortality. Key factors include insulin resistance, visceral adiposity, atherogenic dyslipidemia, endothelial dysfunction, genetic susceptibility, elevated blood pressure, hypercoagulable state, and chronic stress. Chronic inflammation, associated with visceral obesity and insulin resistance, is marked by the production of adipocytokines such as TNF-α, IL-1, IL-6, leptin, and adiponectin. These factors contribute to a proinflammatory state and chronic, subclinical vascular inflammation, promoting atherosclerotic processes. Lifestyle modification is the initial intervention for MetS, combining diet, exercise, and behavioral strategies. Pharmacological treatment is considered for those with inadequately reduced risk factors. The review summarizes literature on MetS definition, epidemiology, pathogenesis, and treatment approaches. MetS is defined by a constellation of factors that increase the risk of atherosclerotic cardiovascular disease (ASCVD), T2DM, and mortality. Definitions vary, but the most commonly used are from the World Health Organization (WHO), European Group for the study of Insulin Resistance (EGIR), National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III), American Association of Clinical Endocrinologists (AACE), and the International Diabetes Federation (IDF). Epidemiological data show worldwide prevalence ranging from <10% to 84%, with higher rates in certain populations. Risk factors include higher socioeconomic status, sedentary lifestyle, and high BMI. The prevalence increases with age and is associated with various metabolic and cardiovascular risks. Pathophysiology involves chronic low-grade inflammation, insulin resistance, dyslipidemia, hypertension, and endothelial dysfunction. Adipose tissue, particularly visceral fat, contributes to inflammation and the release of adipocytokines that exacerbate metabolic complications. Treatment strategies include lifestyle modification, diet, physical activity, and pharmacological interventions. Pharmacological approaches include appetite suppressants and nutrient absorption inhibitors, while bariatric surgery is recommended for severe obesity. The review emphasizes the importance of early identification and management of MetS to reduce long-term risks. Overall, a multidisciplinary approach is essential for effective management of MetS.A comprehensive review on metabolic syndrome (MetS) highlights its role as a major public health challenge, characterized by a cluster of interconnected physiological, biochemical, clinical, and metabolic factors that increase the risk of cardiovascular disease, type 2 diabetes mellitus (T2DM), and all-cause mortality. Key factors include insulin resistance, visceral adiposity, atherogenic dyslipidemia, endothelial dysfunction, genetic susceptibility, elevated blood pressure, hypercoagulable state, and chronic stress. Chronic inflammation, associated with visceral obesity and insulin resistance, is marked by the production of adipocytokines such as TNF-α, IL-1, IL-6, leptin, and adiponectin. These factors contribute to a proinflammatory state and chronic, subclinical vascular inflammation, promoting atherosclerotic processes. Lifestyle modification is the initial intervention for MetS, combining diet, exercise, and behavioral strategies. Pharmacological treatment is considered for those with inadequately reduced risk factors. The review summarizes literature on MetS definition, epidemiology, pathogenesis, and treatment approaches. MetS is defined by a constellation of factors that increase the risk of atherosclerotic cardiovascular disease (ASCVD), T2DM, and mortality. Definitions vary, but the most commonly used are from the World Health Organization (WHO), European Group for the study of Insulin Resistance (EGIR), National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III), American Association of Clinical Endocrinologists (AACE), and the International Diabetes Federation (IDF). Epidemiological data show worldwide prevalence ranging from <10% to 84%, with higher rates in certain populations. Risk factors include higher socioeconomic status, sedentary lifestyle, and high BMI. The prevalence increases with age and is associated with various metabolic and cardiovascular risks. Pathophysiology involves chronic low-grade inflammation, insulin resistance, dyslipidemia, hypertension, and endothelial dysfunction. Adipose tissue, particularly visceral fat, contributes to inflammation and the release of adipocytokines that exacerbate metabolic complications. Treatment strategies include lifestyle modification, diet, physical activity, and pharmacological interventions. Pharmacological approaches include appetite suppressants and nutrient absorption inhibitors, while bariatric surgery is recommended for severe obesity. The review emphasizes the importance of early identification and management of MetS to reduce long-term risks. Overall, a multidisciplinary approach is essential for effective management of MetS.