This article provides an overview of the metabolic syndrome, a collection of cardiovascular risk factors that denote a high-risk, multifactorial,adverse cardiovascular state, which is largely the result of obesity and resulting insulin resistance. Treatment for the metabolic syndrome should be focused primarily on modifying lifestyle,with reduction of the underlying obesity and insulin resistance. A combination of chemoprevention and lifestyle modification may prevent many if not most cases of diabetes if treatment is instituted early.