Focusing on the exciting field of research covers the mechanisms and molecules that involved in the pathogenesis of the metabolic syndrome . Specific topics include the changing areas of interest, such as fetal growth, oxidative stress, inflammation and adipocytokines, and also including vascular complications, atherothrombosis, genetics had been inserted. Over the past few years there has been an exponential increase in interest the Metabolic Syndrome best described perhaps as a clustering of closely related cardiovascular disease (CVD) risk factors. Since the original ‘description’ of the metabolic syndrome, the ‘hypertension- hyperglycaemia-hyperuricaemia syndrome’, early in the last century by a Swedish physician, Eskil Kylin, it has been recognised that concurrent CHD and type 2 diabetes often occur in overweight patients. Reaven linked resistance to insulin-stimulated glucose uptake, with increased blood pressure, glucose concentrations and dyslipidaemia. Undoubtedly much will be learned over the next few years about the aetiology. There will be a search for new drugs which can treat several of the components of the syndrome.