Background: Diabetes mellitus (DM 2) and acute coronary syndrome (ACS) occupy the two leading causes of morbidity mortality in Mexico. The clinical importance of metabolic syndrome (MS) is to be identifi cable and correctable precursor of diabetes and cardiovascular disease. Objective: To determine the prevalence of the metabolic syndrome in patients with coronary syndrome acute. Methodology: Prospective cross-sectional study. Adults with the diagnosis corroborated SICA have been studied and you are looking for the presence of SM NACEP (ATP III) criteria. Results: They were collected 110 (N) patients, 66.3% male and 33.6% female, with an average age of 62.5 years. 76.3% had acute myocardial infarction and 23.6% unstable angina. Gurantee the diagnosis of SM in 67.2% of patients with 59.4% were male and 40.5% women. SICA and SM Association found: 58 patients with acute myocardial infarction, 16 SM and unstable angina, 26 SM and acute myocardial infarction and 10 SM and unstable angina and SM. Conclusions: The metabolic syndrome occurs in three quarters of patients admitted to emergency with diagnosis of acute coronary syndrome. The foregoing suggests that the early diagnosis and prompt treatment of metabolic syndrome will impact on the incidence of ACS.