A BSTRACT Aim: This study was undertaken to assess the association between periodontitis and metabolic syndrome. Materials and Methods: A case-control study was designed among 100 cases as patients with metabolic syndrome aged 35–74 years, and age- and sex-matched 100 controls as apparently healthy relatives or friends accompanying the cases visiting the diabetic outpatient department at Victoria Hospital, Bengaluru, Karnataka, India, using convenience sampling method. Information related to diabetes, hypertension, and oral hygiene practices was collected. Periodontal health status was measured using community periodontal index. Metabolic syndrome was diagnosed based on the criteria of National Cholesterol Education Program Adult Treatment Panel III. Chi-square test and logistic regression were used for analysis. Results: Significantly more number of cases had shallow pockets 4–5 mm, deep pockets ≥ 6 mm, and also more number of loss of attachment code 1, code 2, code 3, and code 4 compared to controls. Bivariate analysis showed significant association between metabolic syndrome and body mass index, smoking, and tobacco chewing. The association between periodontitis and metabolic syndrome was significant with increased risk of developing metabolic syndrome among the subjects with community periodontal index code 3 and code 4 (odds ratio [OR] = 17) and among the subjects having loss of attachment code 1, code 2, code 3, and code 4 (OR = 12). Association remained significant even after adjustment with other variables (adjusted OR = 6). Conclusion: This study showed significant association between periodontitis and metabolic syndrome. Further prospective and randomized control trials are recommended to assess causal association between these two diseases.