Metabolic syndrome (MS) is a state that is somewhat more frequent in people with certain mental disorders and that is related to different types of stress. The position of MS among subjects with PTSD has not been unambiguous and simple in the research so far. The aim of this study was to establish the frequency of MS among patients with combat PTSD; and to establish the possible effect of every single group (cluster) of symptoms of PTSD onto the frequency of MS; the effect of depressiveness and/or anxiety on MS; and also other factors (e.g. physical activity, drug usage, intensity of childhood trauma and intensity of primary trauma leading to the development of PTSD). The subjects in this study were 115 male Croatian Homeland war veterans who experienced combat traumas and developed symptoms of PTSD. The levels of anxiety, depression and intensity of PTSD symptoms have been measured by two set of scales – self reported and interviewer administered. The intensity of the traumatisation has been measured and data on sociodemographic characteristics and drug usage have been collected. The presence of MS symptoms was determined according to NCEP ATP III criteria. This study established that 38.3% of subjects with combat PTSD had MS. There was no correlation between the intensity of PTSD and MS; on the contrary, subjects with higher intensity PTSD symptoms had less often visceral obesity. Among the individual clusters of symptoms, the higher the results on the cluster of hyperarousal symptoms, the more frequent MS; while avoidance symptoms and emotional numbing symptoms showed a tendency (but did not reach statistical significance) toward less frequent visceral obesity. Subjects with MS had higher levels of anxiety; and there were no differences in terms of depression. The level of traumatisation (the intensity of combat trauma) was not correlated to MS; while wounded subjects had visceral obesity less frequent. Subjects with more severe PTSD had significantly higher levels of depression and anxiety. There was a linear relationship between age and number of MS symptoms. Subjects with MS had higher GGT values, and did not differ from non MS subjects according to smoking or physical activity. Subjects without MS more often used citalopram. Subjects with MS more often used drugs effecting cardiovascular system, antidiabetic and antilipemic drugs and had more medical conditions (somatic comorbidity). Subjects without MS had criminal and offence history more often. This research showed that in PTSD patients, age, anxiety, hyperarousal cluster of PTSD symptoms, drinking alcohol, and medical conditions influence the presence of MS. Also, the intensity of PTSD symptoms was not correlated to MS; on the contrary, the more intense PTSD symptoms, the less frequent visceral obesity. There is overlapping between PTSD, depression and anxiety. This kind of relationship among PTSD, depression and anxiety can be due to interrelated influences of hypocortisolemia and increased noradrenergic activity in PTSD patients. PTSD is a heterogeneous disorder with three (or four) clusters of symptoms, interrelated and overlapping with depression and anxiety. Biochemical changes in PTSD (hypocortisolemia and increased activity of sympathetic nervous system) can have different effects on different components of MS. Therefore PTSD does not have unambiguous effect onto the development of individual MS components and MS itself. But, there is unambiguous effect of age and anxiety.