Metabolic syndrome is a public health problem defined by a cluster of interconnected components that increase the risk of cardiovascular atherosclerotic diseases and T2DM. Metabolic syndrome has a pleiotropic pathophysiology related to increasing body fat and distribution and insulin resistance. Recently approved anti-obesity drugs can be prescribed to reduce body weight, particularly abdominal visceral fat. Anti-diabetics such as metformin, lipid-lowering medications, RAAS blockers, and calcium channels exert many metabolic effects including anti-inflammation. Treatment is best achieved with a combination of lifestyle modifications and therapeutic agents that can help reduce insulin resistance, and others that target specific components of metabolic syndrome.