Background: Metabolic syndrome is a group of abnormal laboratory and physical findings, such as dyslipidemia, hypertension, glucose intolerance, proinflammatory state, and prothrombotic state that results in a patient having significantly higher risk for atherosclerosis, cardiovascular disease, and overall mortality. There are slight differences between institutions in defining metabolic syndrome across the world. To achieve adequate management and treatment and decrease the risk of subsequent diseases, proper identification of symptomatic patients with metabolic syndrome is necessary. Aim: In this review, we aimed to study the pathophysiology behind the development of metabolic syndrome, and also to explore the approach to its management. Materials and Methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: metabolic syndrome, pro-thrombotic state, pro-inflammatory state, diabetes mellitus, insulin resistance, obesity and cardiovascular mortality. Results: The major aspects of treatment include weight reduction by diet, medication, as well as bariatric surgery (in some cases), and managing hyperglycemia and insulin resistance with diet and medication. Conclusion: The most important intervention in managing patients with metabolic syndrome is lifestyle modification with improved diet and exercise. To achieve adequate treatment and decrease the risk of adverse outcomes, proper identification of symptomatic patients with metabolic syndrome is necessary.