The metabolic syndrome is a constellation of cardiovascular disease risk factors predisposing to future cardiovascular disease events as well as the development of type 2 diabetes mellitus. This syndrome is closely linked to both subclinical atherosclerosis and vascular inflammation. The extent of vascular inflammation can be estimated by a number of biomarkers, such as high-sensitivity C-reactive protein, that are associated with the presence of the metabolic syndrome. Evaluating for the presence of subclinical atherosclerosis and inflammatory biomarkers may help to risk stratify patients with the metabolic syndrome.