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Objective: This study aimed to evaluate the prevalence of metabolic syndrome (MetS) in Italian patients with bipolar disorder (BD) and to determine the sociodemographic and clinical correlates of MetS in this patient population., Method: Subjects with BD I and II were included. Sociodemographic and clinical characteristics, lifestyle information (alcohol and smoking habits and rate of physical exercise) and comorbidity for cardiovascular diseases and diabetes were collected. Patients were assessed for MetS according to both National Cholesterol Education Program Adult Treatment Panel III and International Diabetes Federation (IDF) criteria., Results: MetS was evaluated in 99 patients out of 108 who were enrolled. MetS was present in 25.3% of the sample. Abdominal obesity was present in 50%, hypertension in 40%, high triglycerides in 34.7%, low HDL-C levels in 32.3% and fasting hyperglycemia in 11% of the sample. Prevalence of MetS was 30% when IDF criteria were employed. Of the investigated variables, age, duration of illness, rate of obesity and cardiovascular disease were higher in patients with MetS. After the regression analysis, only age and obesity were associated to MetS., Conclusions: MetS is highly prevalent in Italian patients with BD. Our 25.3% prevalence rate is consistent with the 21-22% reported in other European studies and lower than that in U.S. studies. Elderly and obese patients with BD are at particularly high risk for MetS.