Aim: To compare prevalence of obstructive sleep apnea (OSA) in metabolic syndrome (MetS) patients and age, sex-matched controls without MetS. Materials & Methods: A total of 50 MetS patients (as per IDF criteria) and a total of 100 age and sex-matched individuals without MetS were enrolled in the study as cases and controls. Screening for OSA was done using Berlin Questionnaire. OSA prevalence was ascertained by polysomnography. Apnea-Hypopnea index (AHI) 5-15, 16-30 and >30 was considered as mild, moderate and severe OSA. Data was analyzed using Chi-square and Independent sample t-tests. Results: Mean age of cases was 50.80±10.16 years. Majority of cases were males (80%). Mean BMI, waist circumference, SBP, DBP, FBS and TG of cases were significantly higher while mean HDL was significantly lower as compared to that of controls (p<0.001). Number of MetS factors 3, 4 and 5 were seen in 28%, 34% and 38% respectively in cases and 0, 1, 2 and 3 in 22%, 47%, 30% and 1% controls respectively (p<0.001). Prevalence of OSA was 58% in cases as compared to 20% in controls (p<0.001). Mild, moderate and severe OSA was seen in 10%, 22% and 26% of cases and 12%, 6% and 2% of controls (p<0.001). On overall evaluation and in case groups, there was a significant increase in prevalence and severity of OSA (p<0.05). Conclusion: MetS patients were at a high risk for moderate to severe OSA. Clinical Significance: Prevention and control of OSA must be targeted as the treatment goal in MetS.