Only few studies about neck circumference (NC) as a measure of cardio metabolic syndrome available from India. Study was conducted to establish an association between neck circumference and cardio metabolic syndrome.Cross-sectional study was conducted in a tertiary care hospital in South India. NCEP: ATPIII 2001 guideline was used for diagnosis of Cardio-metabolic syndrome among subjects. Neck circumference was measured and it was correlated with Cardio-metabolic syndrome.Mean neck circumference was found to be 36.5 cms. Cardio-metabolic syndrome was present in 272 participants, of which 100 were females and 172 males. Among females 82(82%) had neck circumference >34cms, 18(18%) had 37cms and 55(32%) had NC37 cm and women with NC >34 cm are more prone for cardio metabolic syndrome and require additional evaluation. Measurement of NC is a simple, time saving, and least invasive measurement tool.