Background: The impact of metabolic syndrome (MS) on different surgical operations has gained significant attention recently. However, to date, it is unclear whether the medications used to treat MS can have an effect on surgical complications. Objectives: In this study, we aimed to investigate the effects of therapeutic agents used for the treatment of metabolic syndrome on surgical complications. Methods: We performed a retrospective case-control study based on chart reviews of 2624 surgical patients at our hospital in 2016. Data regarding surgical complications obtained from the hospital records were analyzed using binary logistic regression. The independent variables were angiotensin-converting-enzyme inhibitor, angiotensin receptor blocker (ARB), dihydropyridine calcium-channel blockers (DCCB), diuretics, potassium-sparing diuretics, nondihydropyridine calcium-channel blockers (NDCCB), dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 receptor agonists (GLP1 agonists), nonselective beta-blockers, selective beta-blockers, peripheral vasodilators, alpha-glucosidase inhibitors, insulin, metformin, sulfonylureas, thiazolidinediones, bile acid sequestrants, fibrates, and statins. The dependent variable was surgical complications. Among the surgical patients included in the study, 328 (12.5%) had a history of metabolic syndrome. Results: In diseases with the same severity score [≥ ASA 3(American Society of Anesthesiologists)], diuretics, NDCCB, DCCB, insulin, GLP1 agonists, and selective beta-blockers had a significant influence in univariate logistic regression. However, multivariate logistic regression using control variables showed that only diuretic use was statistically significant (odds ratio 1.968, 95% confidence interval 1.141-3.394, p = 0.015).