The article reviews the potential of the triglyceride-to-high-density lipoprotein (TG/HDL) ratio as a surrogate biomarker for insulin resistance (IR). IR, a key factor in metabolic syndrome, is associated with changes in lipid metabolism, particularly elevated triglycerides and reduced HDL cholesterol. The TG/HDL ratio, therefore, reflects these changes and has been proposed as a simple and cost-effective alternative to more complex biomarkers. The review, following PRISMA guidelines, analyzed 32 studies involving 49,782 participants from diverse ethnic backgrounds, including adults and children. The analysis used cross-sectional methods with the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) to assess IR. The results show that the TG/HDL ratio has varying predictive power across different ethnicities and genders, with specific thresholds providing greater accuracy for Caucasians, Asians, and Hispanics over African Americans and for men over women. The median cutoff values for women were 2.53, and for men, 2.8. The study suggests that the TG/HDL ratio is a valuable marker for IR, especially in non-obese individuals and pediatric populations, but its effectiveness varies, and further research is needed to refine cutoffs and integrate it with other biomarkers.The article reviews the potential of the triglyceride-to-high-density lipoprotein (TG/HDL) ratio as a surrogate biomarker for insulin resistance (IR). IR, a key factor in metabolic syndrome, is associated with changes in lipid metabolism, particularly elevated triglycerides and reduced HDL cholesterol. The TG/HDL ratio, therefore, reflects these changes and has been proposed as a simple and cost-effective alternative to more complex biomarkers. The review, following PRISMA guidelines, analyzed 32 studies involving 49,782 participants from diverse ethnic backgrounds, including adults and children. The analysis used cross-sectional methods with the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) to assess IR. The results show that the TG/HDL ratio has varying predictive power across different ethnicities and genders, with specific thresholds providing greater accuracy for Caucasians, Asians, and Hispanics over African Americans and for men over women. The median cutoff values for women were 2.53, and for men, 2.8. The study suggests that the TG/HDL ratio is a valuable marker for IR, especially in non-obese individuals and pediatric populations, but its effectiveness varies, and further research is needed to refine cutoffs and integrate it with other biomarkers.