PurposeThis study examined the determinants of the prevalence of factors related to five components of metabolic syndrome in the elderly. MethodsThe study used raw data (2010–2012) from the Korea National Health and Nutrition Examination Survey-V. The 3971 study subjects were community-dwelling elderly adults aged over 65years. The criteria for the metabolic syndrome were based on those of the American Heart Association/National Heart, Lung and Blood Institute, and the waist circumference cutoff points for these factors were adapted from the standard suggested by the Korea Society for the Study of Obesity in 2005. ResultsThe overall prevalence of metabolic syndrome in Korean elderly adults was 43.6% (35.3% in men and 50.2% in women). Metabolic syndrome was 2.32 times more prevalent in women relative to men (95% confidence interval [CI]: 1.85–2.90, p<0.001), 1.26 times more prevalent in urban, relative to rural, residents (95% CI: 1.09–1.45, p=0.002), 1.43 times more prevalent in ex-smokers (95% CI: 1.14–1.80, p=0.002) and 1.45 times more prevalent in smokers (95% CI: 1.11–1.54, p=0.007) relative to nonsmokers, and 1.16 times more prevalent in sedentary, relative to active, subjects (95% CI: 1.02–1.32, p=0.028). ConclusionThe results indicated that the prevalence of metabolic syndrome in elderly Korean adults was high, suggesting that the prevention and management of metabolic syndrome in the elderly should be addressed via individual components.