Objectives The aim of this study was to determine whether the serum nitrite plus nitrate (NO x ) level correlates with biomarkers that are known components of the metabolic syndrome (MetS). Methods Serum NO x levels were measured using a commercial kit in 608 Japanese men and women between the ages of 39 and 85 years. Multivariate adjustments for age, smoking status, alcohol consumption and exercise were made in the analysis of covariance (ANCOVA). The components of the metabolic syndrome were defined based on the following criteria: body mass index (BMI) C25.0 kg/m 2 , glycated hemoglobin (HbA1c) C5.6%, systolic blood pressure C130 mmHg or diastolic blood pressure C85 mmHg, high-density lipoprotein-cholesterol (HDL-C) B1.03 mmol/l for men and B1.29 mmol/l for women and triglyceride C1.69 mmol/l. Results The logarithmically transformed age-adjusted serum NO x (lnNO x ) value was significantly higher in the low HDL-C group (1.76 ± 0.05 lmol/l; p \ 0.05) than MetS component groups (1.65 ± 0.01 lmol/l) in men, but no difference was found in women. The means of serum lnNO x after multivariate adjustment were 1.64, 1.65, 1.64, 1.66, and 1.81 lmol/l for 0, 1, 2, 3, and 4-5 MetS components for all subjects, respectively. The results of ANCOVA confirmed that the serum lnNO x level was significantly correlated with the clustering of MetS components in both men and women (p \ 0.0001 for trend). Conclusion Our results suggest that an increase in the clustering of MetS components was associated with the increase in serum NO levels in our general population.