The metabolic syndrome is a complex condition characterized by dyslipidaemia, high blood pressure, impaired glucose tolerance and abdominal fat accumulation. Subjects with the metabolic syndrome are at high risk of atherosclerosis and coronary heart disease. A comprehensive approach is required for patients suffering this cluster of clinical manifestations. Indeed, subjects with the metabolic syndrome could benefit from life-style modifications, particularly through exercise and diet. In this article, the evidence regarding the role of diet, in particular the role of food patterns based on the Mediterranean-style diet, in preventing and treating the metabolic syndrome are reviewed.