Background Metabolic syndrome (MetS) is described as a cluster of cardiometabolic risk factors that can increase the possibility of developing atherosclerotic cardiovascular diseases. According to monastic rules, Thai Buddhist monks are not allowed to cook meals and do exercise. This unique lifestyle generally encompasses low physical activities and may cause several noncommunicable diseases. Thus, in this study, we aimed to examine the prevalence, risk factors, and perception of MetS among Thai Buddhist monks. Methods This was a cross-sectional study conducted among Thai Buddhist monks living in Tha Luang District, Lopburi Province, Central Thailand. Study participants completed a questionnaire inquiring about personal and health data, and they also underwent physical examination, including anthropometric measurements, before undergoing biochemical blood tests. MetS was defined based on the National Cholesterol Education Program ATP III (NCEP ATP3) criteria. A qualitative study using in-depth interview was conducted to determine the knowledge and perceptions regarding MetS among Thai Buddhist monks. Results In total, 96 Thai Buddhist monks were included in this study. The prevalence of MetS was 28.1%. Participants who had a body mass index of \(\ge\)25 kg/m2 were determined to have a higher risk of developing MetS (OR, 4.5; 95% CI, 1.6–13.3). The in-depth interview revealed that participants’ perceptions were directly associated with their beliefs, experience, and basic healthcare knowledge. A qualitative study identified two primary factors of MetS among Thai Buddhist monks, viz., unhealthy diet and low physical activity. Conclusions MetS prevalence in Thai Buddhist monks was moderate compared with that reported by other studies. Medical providers and Buddhist devotees should cooperate in providing health promotion by donating healthy food, conducting annual health checkups, and arranging alternative exercises in a private area that correspond with the monastic rules. Therefore, early screening, treatment, and patient education are the most important factors to manage MetS in Thai Buddhist monks.