Aim: The aim of the present study was to determine the prevalence of the metabolic syndrome using Adult Treatment Panel III (ATP III) criteria in Adana, a southern province of Turkey. Methods: The randomly selected study population included 1637 adults who were 20-79 yr of age. The presence of greater than or equal to3 of components like hypertension (defined as blood pressure >130/ greater than or equal to85 mmHg on two separate examinations, or usage of antihypertensive agents), visceral obesity (waist circumference >88 cm in females and >102 cm in men), low HDL cholesterol level (<1.04 mmol/l in men and <1.29 mmol/l in females), high triglyceride level (a fasting triglyceride level greater than or equal to1.7 mmol/l), fasting glucose level greater than or equal to6.1 mmol/l, or usage of antihyperglycaemic drugs, indicated the metabolic syndrome. Results: The prevalence of the metabolic syndrome was 33.4% and more common in women than in men (39.1 vs 23.7%; p<0.0001). Both women and men with the metabolic syndrome were older than subjects without. In men, frequencies of the metabolic syndrome in urban and rural areas were similar (23.1 vs 24.3%; p>0.05), but were markedly higher among women in rural than urban areas (44.5 vs 31.2%; p<0.0001). Conclusions: Developing countries like Turkey also need to start action to prevent and treat the components of the metabolic syndrome. Prevention of the modifiable risk factors, such as obesity and physical inactivity, and blood pressure control should be the key strategy for avoiding mortality and financial costs of the healthcare system, especially in view of limited resources. (C) 2004, Editrice Kurtis.