Overweight and obesity are highly prevalent in Kuwait and they are associated with the metabolic syndrome (MS). The present study aims to assess the prevalence of the MS among Kuwaiti female adolescents aged 10 -19 years. A cross-sectional random sample of 431, apparently healthy, Kuwaiti female adolescents drawn from several randomly selected schools was studied for the prevalence of the MS using the International Diabetes Federation (IDF) and the National Cholesterol Education Program Third Adult Treatment Panel (ATP III) modified for age diagnostic criteria. Clinical assessment included measurements of waist circumference, blood pressure, fasting blood glucose, HDL and TAG. Whichever criteria are used, the prevalence of the MS among female Kuwaiti adolescents was found to be high, which indicates an urgent need for intervention programmes to prevent increased CVD and type 2 diabetes mellitus. The IDF criteria tend to give higher values for the prevalence of the MS in comparison with the modified ATP III criteria (14·8 v. 9·1 %). There have been no diagnostic criteria specific for the MS for the Gulf Arab population as yet. The prevalence of overweight (BMI $ 25 kg/m 2 ) and obesity (BMI $ 30 kg/m 2 ) has been on the increase in the Gulf Arab population, primarily among children, adolescents and young adults (1) . In Kuwait, the overall prevalence of overweight and obesity has been found to be 30·9 and 13·9 %, respectively, among adolescents aged 10-14 years, which probably increased through the years due to the effects of modernisation, increased food consumption and sedentary lifestyles (2,3) . The prevalence of overweight and obesity was 28·6 and 7·9 %, respectively, among Qatari adolescents (4) , 21·5 and 13·7 % in United Arab Emirates (5) and in Saudi Arabia the prevalence of obesity ranged from 33·9 % in Ha'il to 11·7 % in Jizan.Overweight and obesity are associated with the metabolic syndrome (MS) (6) , even in children (7) . The MS has been shown to be associated with a variety of morbid conditions, chief among which are CVD or type 2 diabetes mellitus (T2DM) (8) ; it doubles the risk for CVD and further raises the risk for T2DM by about 5-fold (9) . According to the WHO, non-communicable diseases, including CVD and T2DM, were responsible for 52 % of the Eastern Mediterranean region's disease burden in 2006, and expected to rise to 60 % by 2020 (10) . In adults, mortality resulting from CVD is significantly higher with the MS than those not suffering from the MS (11) . Paediatric MS predicts significantly the MS and T2DM 25 to 30 years later (12) , and predicts CVD 25 years later (13) . Furthermore, the MS was found highly associated with increased CVD and all-cause mortality even in the absence of previous history of CVD and diabetes (14) , especially with the combination of elevated waist circumference, elevated glucose, either elevated blood pressure or elevated TAG, and the combination of all four of these MS individual parameters (15) . Waist circumference is a simple measure by which abdominal ob...