Background: Metabolic Syndrome (MetS) is a set of interrelated clinical disorders, including dyslipidemia, central obesity, glucose intolerance, and high blood pressure. Hyperuricemia is known to cause various inflammatory diseases via uric acid deposition in the joints. Present study was aimed to study serum uric acid in patients with metabolic syndrome at a tertiary care hospital in rural Tamilnadu. Material and Methods: Present study was comparative, observational study, conducted in patients of age > 18 years, either gender, case of metabolic syndrome (cases) & healthy, age & gender matched subjects (controls). Results: In present study 400 cases & age, gender matched 400 controls were participated. We noticed that systolic blood pressure, diastolic blood pressure, fasting blood sugar & triglycerides were significantly higher among patients with metabolic syndrome as compared to controls & difference was statistically significant (p<0.001). While, high-density lipoprotein, total cholesterol & low-density lipoprotein (mg/dL) were comparable in both groups & difference was not significant statistically (p>0.05). In patients with metabolic syndrome higher levels of uric acid (6.78 ± 1.05) were noted as compared to controls (5.16 ± 0.95), difference was statistically significant (p<0.001).In patients of metabolic syndrome higher levels of uric acid were noted in patients with BMI > 30 kg/m2 (6.17 ± 1.02 vs 4.81 ± 0.92), Fasting Blood Sugar ≥100 (6.29 ± 1.09 vs 4.92 ± 0.99), blood Pressure ≥130/85 (6.27 ± 1.13 vs 5.29 ± 1.01) & triglycerides > 150 mg/dL (6.05 ± 0.99 vs 5.53 ± 1.21), difference was statistically significant (p<0.001). Conclusion: Elevated levels of uric acid were seen in patients with metabolic syndrome and also in components of metabolic syndrome such as body mass index, fasting blood sugar, blood pressure & triglycerides.