Objectives: The purpose of this research was to investigate incidence and related factors of the MS in a university hospital Methods: This survey was conducted from January in 1997 to March in 2008. This study is a cohort study. The baseline subjects were 529 men and 609 women without metabolic syndrome(MS) who visited the health promotion center of Chungnam National University Hospital for general health check-up. The MS was diagnosed according to the definition by the NCEP ATP III. The abdominal obesity guidelines for waist circumference applied the Korean Society for the Study of Obesity Guideline Results: The survey exhibited that baseline risk factors that mainly affect odds ratio(OR) of the MS at follow-up were sex, ages, heavy drinking, uric acid and transpeptidase(GGT) in women. Incidence of the MS was 10.6% in total cases, 18.1% in men and 4.0% in women. The risk of the MS was significantly lower in women than men(OR=0.4, 95% confidence interval(CI: 0.2-0.9), significantly higher 50-59 Ages than < 40 ages(OR=3.4, 95% CI: 1.9-6.4), significantly high in women with heavy drinkers(OR=14.3, 95% CI: 1.2-177.5), significantly high in whole, men and women with high uric acid group(whole, OR=2.6, 95% CI: 1.6-4.2. men, OR=2.1, 95% CI: 1.3-3.5. women, OR=14.2, 95% CI: 3.0-68.3) and significantly high in women with high GGT(OR=1.8, 95% CI: 2.4-12.6). Conclusion: Risk factors of incident MS were baseline sex, ages, heavy drinking in women, uric acid and GGT in women. These can be utilized as an important index to determine risk factors of incident MS and will be basic data in part of management, education, countermeasure and selection test of the MS.