The metabolic syndrome diagnosis is important to identify populations at higher risk of CVD and of type 2 diabetes in particular. So far, clinical criteria proposed to identify individuals with the metabolic syndrome have mostly been derived from Caucasian populations. This review paper underlines the importance of considering ethnicity when estimating metabolic syndrome-related risk. Accordingly, the paper discusses differences in CVD risk factors for metabolic syndrome criteria and in the clustering of metabolic syndrome variables across ethnic groups.