Aim: Aim of this study was to evaluate the possible association between the metabolic abnormalites characteristic of the Metabolic Syndrome (MetS), according to NCEP-ATPIII, and the prostatic adenomyomatosis or prostate cancer. Methods: 111 patients were enrolled. Subjects underwent a medical examination including digital rectal exploration (DRE), prostate-specific antigen (PSA) determination and, when indicated a transrectal ultrasonography (TRUS) with prostate biopsy. Patients were subsequently divided into 3 groups: subjects with DRE -, TRUS - and PSA < 4 ng/ml (controls, n=24); patient with histological diagnosis of prostate cancer (PC n=32) and patient with prostatic alterations (DRE+ and/or TRUS + and/or PSA > 4 mg/dl) without histological evidence of prostate cancer (DRE/TRUS/PSA+/Bio- n=55). Results: Total cholesterol, LDL-chol and not-HDL-chol were significantly lower in the DRE/TRUS/PSA +/Bio - group compared to controls and PC group. Triglycerides, glycemia, HDL-chol and insulin sensitivity, estimated with HOMA index, were not significantly different however the prevalence of the glycemic criteria for MetS was significantly higher in the DRE/TRUS/PSA +/biopsy - group. The three groups did not differ in terms of adiposity index except for BMC which was significantly lower in PC group. Prevalence of MetS was similar in the 3 groups however subjects in the DRE/TRUS/PSA+ Bio - group met a significantly higher number of diagnostic criteria for MEtS. Conclusions: Our results support a possible association between MetS and benign prostatic hyperplasia while metabolic abnormalities do not seem to be associated with prostate cancer.