Globally, there is an increase in the Prevalence of Metabolic Syndrome. The rise in prevalence of Metabolic Syndrome suggests burden of Cardiovascular related morbidity and mortality which is also prevalent in Nepal. Metabolic Syndrome confers a 5-fold increase in the risk of Type 2 Diabetes Mellitus (T2DM) and 2-fold the risk of developing Cardiovascular Disease (CVD) over the next 5 to 10 years. Routine surveillance and registry system in Nepal related to Metabolic Syndrome are bare in Nepal which is imperative to determine the prevalence of MetS and its associated factors. This study used multistage cluster sampling considering the three ecological zones as strata. 259 Primary Sampling Units were selected randomly and a total of 5593 population were surveyed where 5051 population met the criteria for determining the Prevalence of MetS. A STEPwise Surveillance was conducted using WHO Steps survey questionnaire 3.2 version by interview technique, physical and biochemical measurements. The result concluded that there was a decrease in trend of Prevalence of Metabolic Syndrome from 14.1% to 6.69%. from 2013 to 2019.The overall Prevalence of MetS was found to be 6.69%, nearly double in women than in men (8.62% and 4.57% respectively). Waist circumference was found to be the most prevalent component of Metabolic Syndrome among women. Age, Sex, Education, Marital status, Wealth quintile and Ecological region were significantly associated with MetS and there was no significant association of MetS with behavioral factors.

The authors have declared no competing interest.

The research was funded by University Grant Commission, Sanothimi, Bhaktapur as Partial Scholarship For Phd Scholar.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The IRB approval has been obtained from Nepal Health Research Council (NHRC)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Not Applicable

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Not Applicable

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Not Applicable

The data are available and stored safely. The author declare that the data is original and is ready to submit the data at any time.