Identifying patients with cardiovascular risks was once the simple process of recognizing the traditional risk factors. However, since the National Cholesterol Educational Program Adult Treatment Panel III guidelines were released in 2001, and again revised in 2004, identification of cardiovascular risk has become more complicated. This article provides both an overview and an update on the metabolic syndrome as a cluster of risk factors for both type 2 diabetes and cardiovascular disease (CVD). Specific issues are discussed as they relate to African-American women and their prevalence of the metabolic syndrome and cardiometabolic risk. Nurses are optimally prepared to identify the early signs of cardiometabolic risk by testing for and assessing the metabolic syndrome. Likewise, nursing is in a position to provide teaching and counsel regarding the needed lifestyle alterations for patients with metabolic syndrome in order to reduce the risk of type 2 diabetes, cardiovascular disease, and/or stroke.