The metabolic syndrome is a cluster of metabolic disturbances that result in an increased risk of type 2 diabetes and cardiovascular disease in adults. Despite the lack of a uniform definition of the syndrome for children, several studies have reported an overall prevalence of 3 to 4% among children. Among obese adolescents, the prevalence can be as high as 30 to 50%. Besides insulin resistance and obesity, the intrauterine environment and genetic factors also seem to play a role in the pathogenesis of the syndrome in children. In view of the current obesity epidemic and since an increasing amount of evidence shows that obesity during adolescence is significantly associated with insulin resistance, abnormal serum lipid levels, and elevated blood pressure during adulthood, there is a great need for a clear definition, for the development of screening guidelines, and for appropriate prevention and treatment strategies for the metabolic syndrome in the pediatric population. Drug Dev. Res. 67:602–606, 2006. © 2006 Wiley-Liss, Inc.