Background: Hypothyroidism and Metabolic Syndrome (MetS) is well-established predecessor of atherogenic cardiovascular disease. MetS includes a group of risk factors characterized by hypertension, hyperglycemia, dyslipidemia, prothrombotic, and proinflammatory conditions, which speed up the body's atherogenic process. Hypothyroidism causes hyperlipidemia, diastolic hypertension, endothelial dysfunction, and cardiovascular disease. Hypothyroidism is also associated with increased cardiovascular morbidity for which various theories have been proposed. One of the hypotheses suggested is causal interaction with the metabolic Syndrome (MetS). The Adult Treatment Panel III report (ATP III) of the National Cholesterol Education Program has identified the MetS as a Multiplex risk factor for cardiovascular disease that deserved more clinical attention