The current study, for the first time, evaluated the predictive value of FRS for estimation of 10-year CVD risk in patients with metabolic syndrome in Iran. Due to relatively high prevalence of metabolic syndrome in Iranian population, the results will be useful for designing interventional strategies to prevent CVD in these patients. In the current study, a potent relationship between FRS risk scores and components of metabolic syndrome has been identified. High SBP and FSG were associated with meaningfully increased risk of CVD compared with other parameters. More studies are needed to further clarify these associations in a longitudinal design.