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Background: Metabolic syndrome (MetS) represents a clustering of cardiometabolic risk factors that significantly increases the risk of cardiovascular disease and progression to type 2 diabetes. Hispanic populations, particularly those of Caribbean origin, carry a disproportionate burden of obesity, insulin resistance, and hypertension, yet remain underrepresented in clinical data. Characterizing MetS in this population is essential for early risk stratification and targeted prevention strategies. Purpose: To evaluate the prevalence and clinical characteristics of MetS among Hispanic patients with prediabetes and type 2 diabetes in a cardiology outpatient setting. Methods: We conducted a retrospective cross-sectional study of 634 adult Hispanic patients (predominantly of Dominican ancestry) with prediabetes or type 2 diabetes. MetS was defined using International Diabetes Federation criteria. Demographic, clinical, and laboratory variables were extracted from electronic health records. Descriptive and comparative analyses were performed. Results: Among 634 patients, MetS was present in 217 individuals (34.23%). The prevalence was higher in patients with type 2 diabetes compared with prediabetes (39.3% vs 28.3%). The cohort was predominantly female (65.8%), with women accounting for the majority of MetS cases (22.7% vs 11.5% in men). Overall, 41.2% of patients had obesity (BMI >30). Patients with MetS demonstrated significantly worse cardiometabolic profiles compared with those without MetS, including higher mean BMI (34.1 vs 27.2 kg/m²), hemoglobin A1c (6.80% vs 6.57%), fasting glucose (121.8 vs 112.5 mg/dL), and triglycerides (132.1 vs 114.6 mg/dL). They also exhibited lower HDL cholesterol levels (48.2 vs 52.6 mg/dL) and higher systolic and diastolic blood pressure. Clustering of risk factors was prominent: 40% of patients had two MetS criteria, 30.0% had three, and 8.7% had four. The average number of MetS components was higher in affected individuals (2.64 ± 0.70 vs 2.00 ± 1.01). Obesity was a central feature, present in 100% of patients with MetS compared with only 6.9% of those without. Additionally, patients with type 2 diabetes exhibited a more adverse metabolic profile across all parameters compared with those with prediabetes. Conclusion: Metabolic syndrome affects approximately one-third of Hispanic patients with prediabetes and type 2 diabetes and is characterized by significant clustering of cardiometabolic risk factors, particularly obesity. These findings highlight the importance of early identification and aggressive risk factor modification in high-risk Hispanic populations to reduce future cardiovascular events.