Background: Women spend one third of their life in menopause. The age related anatomical and physiological changes predispose them to MetS and lower urinary tract symptoms (LUTS). The aim was to study the prevalence of metabolic syndrome (MetS) and lower urinary tract symptoms in postmenopausal women attending menopause clinic, to study the correlation of LUTS and body composition among women with MetS.Methods: 154 post-menopausal women who attended menopause clinic at the Christian Medical College Hospital Vellore, were recruited. MetS was diagnosed using IDF criteria. LUTS were assessed BFLUTS questionnaires. Blood was taken to assess serum fasting glucose and lipid profile. DEXA was performed to assess the whole-body composition.Results: Of 154 postmenopausal women, 64% had MetS and 43% of women had a total LUTS score > 5. 90% of women had filling symptoms,57% had incontinence,17% had voiding symptoms,14 % had quality of life issues and 6 % had sexual symptoms. However, there was no statistical significant difference between two groups in correlating the variables of MetS with LUTS (P >0.05). The percentage of total body fat by DEXA scan was significantly greater (P=0.006) in women with MetS (37.32±5.04) when compared to the women without MetS (34.629±3.65).Conclusions: Prevalence of MetS among the study population was 64 %. LUTS were observed in 43% of the patients. There was no significant difference in LUTS in women with MetS and without Mets. However, there was a significant difference in body composition among women with and without MetS.