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Objective: Determination of both the feasibility and the result in terms of cardiovascular risk factors of self-measurement of waist circumference by apparently healthy people. We also investigated the prevalence of metabolic syndrome in a population of patients aged 20-69 years in IJsselstein, the Netherlands., Design: Cross-sectional survey., Methods: All patients aged 20-69 years in the care of a group of General Practitioners (GPs) in IJsselstein, the Netherlands, who were not known to have diabetes, hypertension or dyslipidaemia (n = 11,862), received a tape measure and instructions by mail with the request to measure their waist circumference. Those with an increased waist circumference (> 88 and > 102 cm for women and men, respectively) were invited to undergo investigations to determine whether they conformed to the NCEP ATP III criteria for metabolic syndrome. The prevalence of metabolic syndrome was determined by a combination of these results with file studies of those with already known risk factors for cardiac and vascular disease., Results: The total response rate was 62%. The intraclass correlation between the waist circumference measured by the respondents and by the investigators was 0.80 (p < 0.05). 473 new cases of metabolic syndrome were detected among 1721 persons with an increased waist circumference on self-measurement, 40 % in people younger than 45 years. The total prevalence among those aged 20-69 years in IJsselstein was 15.5%. Only 39% of the people with the metabolic syndrome were already known to have risk factors., Conclusions: A GP initiated screening system for metabolic syndrome, in which self-measurement of waist circumference was the first step, proved to be feasible and reliable. A substantial group of people aged less than 45 years and at increased cardiovascular risk were also detected using this method of population screening.