Chronic kidney disease is fast becoming a worldwide epidemic. In the US, the prevalence of chronic kidney disease is 11%. Its increase in the recent years has mirrored the rising trend of obesity, hypertension and diabetes, which are all components of the metabolic syndrome. Metabolic syndrome comprises of 5 components: impaired fasting glucose, abdominal obesity, hypertriglyceridemia, hypertension and low high density lipoprotein cholesterol. While it is a well known cardiovascular risk factor in the general population, its effects in chronic kidney disease and dialysis populations has not been fully elucidated. While the number of people requiring renal replacement therapy is increasing globally, many of those with chronic kidney disease also suffer from cardiovascular morbidity and mortality. This review discusses the interaction between chronic kidney disease and metabolic syndrome, and the impact of the two on the cardiovascular risk in patients with chronic kidney disease.