Ambient air pollution and temperature have been linked with cardiovascular morbidity and mortality. Metabolic syndrome and its components-abdominal obesity, elevated fasting blood glucose concentration, low highdensity lipoprotein cholesterol concentration, hypertension, and hypertriglyceridemia-predict cardiovascular disease, but the environmental causes are understudied. In this study, we prospectively examined the long-term associations of air pollution, defined as particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (PM 2.5 ), and temperature with the development of metabolic syndrome and its components. Using covariate-adjustment Cox proportional hazards models, we estimated associations of mean annual PM 2.5 concentration and temperature with risk of incident metabolic dysfunctions between 1993 and 2011 in 587 elderly (mean = 70 (standard deviation, 7) years of age) male participants in the Normative Aging Study. A 1-μg/m 3 increase in mean annual PM 2.5 concentration was associated with a higher risk of developing metabolic syndrome (hazard ratio (HR) = 1.27, 95% confidence interval (CI): 1.06, 1.52), an elevated fasting blood glucose level (HR = 1.20, 95% CI: 1.03, 1.39), and hypertriglyceridemia (HR = 1.14, 95% CI: 1.00, 1.30). Our findings for metabolic syndrome and high fasting blood glucose remained significant for PM 2.5 levels below the Environmental Protection Agency's health-safety limit (12 μg/m 3 ). A 1°C increase in mean annual temperature was associated with a higher risk of developing elevated fasting blood glucose (HR = 1.33, 95% CI: 1.14, 1.56). Men living in neighborhoods with worse air quality-with higher PM 2.5 levels and/or temperatures than average-showed increased risk of developing metabolic dysfunctions. air pollution; blood glucose; high-density lipoprotein cholesterol; hypertension; metabolic syndrome; obesity; temperature; triglycerides Abbreviations: CI, confidence interval; HDL, high-density lipoprotein; HR, hazard ratio; NAS, Normative Aging Study; PM 2.5 , particulate matter with an aerodynamic diameter less than or equal to 2.5 μm.Metabolic syndrome is an urgent public health concern that affects 10%-25% of the global population and is associated with increased risk of cardiovascular disease, asthma, sleep apnea, and selected malignancies and with higher total and cause-specific mortality (1). Metabolic syndrome is defined as having at least 3 of the following conditions: abdominal obesity (waist circumference ≥102 cm for men or ≥88 cm for women), high fasting blood glucose (≥100 mg/dL or medication to treat elevated blood glucose), low high-density lipoprotein (HDL) cholesterol (<40 mg/dL for men, <50 mg/dL for women, or medication to treat low HDL cholesterol), hypertension (systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥85 mm Hg, or medication to treat elevated blood pressure), and hypertriglyceridemia (triglyceride level ≥150 mg/dL or medication to treat elevated triglycerides) (2) (see Web Table 1, available at http://aje. oxfordj...