Objective: Assessment of relation between metabolic syndrome (MS) and Mediterranean diet (MD) adherence. Design: Cross-sectional study. ATP III definition of MS was used. Adherence to MD was assessed with a Food Frequency Questionnaire. Intakes of cereal, fruit, legumes, vegetables, fish, nuts, monounsaturated to saturated ratio, alcohol from red wine, whole-fat dairy products and red meat were considered. Setting: Representative sample of population from the Canary Islands (Spain) participating in the Canarian Nutrition Survey (ENCA). Subjects: 578 adults . 18 years. Results: Of the subjects, 24.4% presented MS. Once adjusted, MD adherence was not related to MS prevalence, but subjects in the third tertile of adherence presented 70% lower prevalence of the blood pressure criteria and 2.5 times more prevalence of the glycaemia criteria with respect to the first tertile. Red meat intake was associated with higher prevalence of blood pressure criteria. Moderate alcohol intake from red wine was associated with lower prevalence of these criteria in women and lower prevalence of HDL cholesterol criteria in men. Fruit intake showed a protective effect on triglyceride criteria, whereas vegetable intake was associated with higher prevalence of this criterion. Cereals' intake showed a protective effect over insulin resistance measured by high insulinaemia level. Fruit intake showed a significative protective effect over high Homeostasis Model Assessment index. Whole-fat dairy products showed a significant protective effect on the glycaemia criteria. High monounsaturated to saturated fatty acid intake showed a protective effect on insulin resistance. Conclusions: Some components of the MD showed a protective effect on the MS and its components.