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Objective: To determine the frequency and impact of metabolic syndrome (MS) in patients with low back pain in rheumatology unit in Benin. Patients and Methods: Analytic cross-sectional study conducted between June and December 2016 in the rheumatology hospital unit of National Hospital University Hubert Koutoukou Maga of Cotonou. 82 patients with mechanical low back pain were selected. The prevalence of MS was defined using the criteria of the International Diabetes Federation 2005. The data were analyzed using epi data and SPSS17.0 software. Results: The mean age was 50.4 ± 14.9 [12 -90] years. The sex ratio was 0.82. 29.3% patients have met diagnostic criteria for MS. The mean duration of back pain was 40 ± 17.2 [3 -120] days. Diseases associated with low back pain were as follow: lumbar intervertebral disk degeneration (34.1%), disk herniation (13.4%), facet joint arthrosis (18.3%), degenerative spondylolisthesis (11%), degenerative lumbar spinal stenosis (6.1%) and related forms (17.1%). MS observed in 24 patients was characterized by the frequent association of abdominal obesity (24 cases), arterial hypertension (22 cases), HDL hypocholesterolemia (8 cases), hyperglycemia (12 cases) or hypertriglyceridemia (7 cases). The presence of the MS was associated with a decreased response to the medical treatment (p < 0.01). Conclusion: The MS is frequent in patients with low back pain in rheumatology unit at Cotonou and influence the treatment response. The management of these patients must be integrated into a multidisciplinary approach including the rheumatologist and nutritionist.