The use of highly active antiretroviral therapy (HAART) transformed HIV infection to a chronic disease, and the complexity of the physiological disorders generated leads to the disruption of body fat distribution and insulin resistance. The resulting metabolic syndrome has rarely been investigated among people living with HIV/AIDS in Cameroon. The aim of the current work was to determine the prevalence of metabolic syndrome and associated factors among people living with HIV/AIDS under HAART at the Bafoussam Regional Hospital in Cameroon. A retrospective, cross-sectional study was conducted to collect demographic, clinical and therapeutic data from 371 people living with HIV/AIDS and who are under HAART at the Bafoussam Regional Hospital from November 2017 to February 2019. Abbott Real-time HIV-1 system, FACSCOUNT cytometer and FULLYSMART automates were used to determine HIV RNA level, CD4 cell count and biochemical parameters respectively. The metabolic syndrome was defined according to the International Diabetes Federation (IDF) and the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria. The overall prevalence of metabolic syndrome was 37.74% by IDF and 28.84% by ATPIII. Among patients with metabolic syndrome, HDL-hypocholesterolemia was the most prevalent feature (92.14%). We found that aging (OR, 1.05; p, 0.005), HIV RNA level (OR, 3.42; p, 0.001), family history of metabolic and coronary heart disease (OR, 2.24; P, 0.04), alcohol consumption (OR, 4; P, 0.004) and nutritional supplements (OR, 3.5; P<0.001) were the independent predictors of metabolic syndrome. Male sex (OR, 0.22; p,<0.001), use of traditional medicines (OR, 0.28; P<0.001), Cotrimoxazole prophylaxis (OR, 0.45; p, 0.007) and Lamivudine-Tenofovir-Efavirenz antiretroviral regimen (OR, 0.26; p<0.001) were protective factors. The prevalence of metabolic syndrome is on the increase among people living with HIV/AIDS in our study population. Both HIV related factors and traditional risk factors were associated with metabolic syndrome.