Background: Metabolic syndrome (MetS) is an important predictor of cardiovascular disease and type 2 diabetes. Its prevalence is rising in India due to rapid lifestyle transitions. Aim: To estimate the prevalence and identify predictors of MetS among adults attending a tertiary care centre, and to compare metabolic parameters with expected normal values. Materials and Methods: A cross-sectional study was conducted among 400 adults aged ≥18 years. Data on sociodemographic factors, anthropometry, blood pressure, and fasting biochemical parameters were collected. MetS was diagnosed using NCEP-ATP III criteria. Expected normal values included waist circumference 40 mg/dL (men) / >50 mg/dL (women). Logistic regression identified independent predictors. Results: The prevalence of MetS was 31.8%. Abnormal component frequencies were: increased waist circumference (44%), low HDL (41%), elevated BP (36%), high triglycerides (32%), and elevated fasting glucose (28%). Significant predictors of MetS included age >45 years (AOR 2.6), BMI ≥25 kg/m² (AOR 3.2), physical inactivity (AOR 2.1), and family history of diabetes (AOR 1.8). Conclusion: Metabolic syndrome is common among adults at a tertiary care centre. Obesity, advancing age, sedentary lifestyle, and family history of diabetes are key predictors. Early screening and targeted lifestyle interventions are essential to mitigate cardiometabolic risk.