Purpose: The purpose of this study was to construct and test a structural equation model to investigate the risk factors of metabolic syndrome in rural women. Methods: The raw data in this study was collected from the Korean Genome and Epidemiology Study supervised by the Korea Centers for Disease Control and Prevention from 2005 to 2010. The data included physical examinations and surveys of 1,125 women, who resided in three rural areas of South Korea. The structural model in this study was composed of five latent variables: depression, stress, social support, health behavior, and metabolic syndrome. The structural equation model was used to assess the relationships among the variables. Results: The results of the study showed that depression and stress had direct effects on metabolic syndrome. Social support had a direct effect on health behavior and metabolic syndrome. Also, health behavior had a direct effect on metabolic syndrome. Conclusion: This study may serve as a guideline for interventions and strategies used to reduce metabolic syndrome in rural women.