BACKGROUND Metabolic syndrome is known to predispose to atherosclerosis. C-reactive protein, a marker of systemic inflammation is significantly associated with the atherosclerotic process. (1) METHODS We prospectively studied the relationship between high-sensitivity C-reactive protein (hs-CRP) with various components of metabolic syndrome in 50 patients with metabolic syndrome at our tertiary care centre in Chennai, Tamil Nadu. RESULTS 50 patients diagnosed with metabolic syndrome were studied. There were 21 males and 29 females. In our analysis, hs-CRP was found to be significantly increased in patients with diabetes mellitus (p < 0.023) with increase in duration of diabetes (p < 0.0446), those whose diabetes was not controlled (p < 0.0365) and those with abnormal waist circumference (p < 0.0019). There was no significant association between hs-CRP and high triglycerides, hypertension, reduced high density lipoprotein cholesterol. HS-CRP increased significantly with increasing number of components of metabolic syndrome (p < 0.0001). HS-CRP was found to be elevated in about two-third (68%) of patients with metabolic syndrome. CONCLUSIONS Measurement of hs-CRP can be used as a surrogate marker of chronic inflammation in patients with metabolic syndrome and has a positive correlation with the number of components met in metabolic syndrome patients.