Introduction: Since the advent of antiretroviral therapy, the vital prognosis of people living with HIV (PLWHA) has improved significantly. However, the risk of metabolic complications is high, thus making the bed of cardiovascular disease. Our objective was to compare the prevalence of metabolic abnormalities among PLWHA receiving ARVs to that observed in those who are not treated. Methods: We conducted a cross-sectional study (January to April 2010) at the PLWHA ambulatory care center of national university hospital (CNHU-Hubert K. Maga) in Cotonou, Bénin. We recruited 420 PLWHA (210 treated for at least 6 months and 210 untreated). We determined the prevalence of metabolic syndrome (MS) defined by the criteria of NCEP-ATP III, and the prevalence of abnormal glucose and lipid, and lipodystrophy. Association between metabolic syndrome and ARVs used was analyzed by binomial regression. Confidence intervals were calculated at 95% and 5% alpha level. Results: The prevalence of MS was 16% (18% of patients treated vs. 13% of non-treated, p = 0.18). That of hyperglycemia was 18% (30% of patients treated vs. 6% of untreated; p < 0.001) and of diabetes 7% (12% of patients treated vs 2% of untreated; p < 0.0001). *Corresponding author. D. M. Zannou et al. 107The total cholesterol prevalence was 29% (44% of treated vs 13% of untreated; p <0.02). That of lipodystrophy in 210 patients was 29% (lipoatrophy16%, lipohypertrophy 8%, mixed form 6%).