Background: Acne vulgaris remains one of the commonest diseases of skin with chronic inflammatory dermatosis that affects 85 p.c of the adolescents and young adults globally. Acne is associated with greater psychological burden that include depression, anxiety, and low self-esteem. It is a multifactorial disease depending on genetic predisposition, follicular epidermal hyperproliferation, endocrine factors, the colonization and activity of Propionibacterium acnes, excess sebum production, inflammation, and environmental factors. Insulin resistance, dyslipidaemia, visceral adiposity, elevated blood pressure and chronic stress are several factors which constitute the metabolic syndrome. Aim & Objectives: To analyse the relationship between Diabetes Mellitus, Dyslipidaemia, Hypertension, and Visceral Adiposity in Acne Vulgaris.Material and Methods: A hospital based, analytical cross-sectional study was conducted among patients aged 14 years & above, irrespective of gender with acne vulgaris, irrespective of severity and attend the outpatient clinic of dermatology at a tertiary care hospital for a period of 12 months. Grading of acne was done according to Global Acne Grading System. Metabolic syndrome was diagnosed as per the criteria of the modified NCEP-ATP III. Results: The patients with severe GAGS had high metabolic syndrome (72.4%) when compared to those without metabolic syndrome (27.6%), there exists an extreme statistically significant association between metabolic syndrome and GAGS (acne severity) with p-value