Abstract : Skin tags or Acrochordons present as pedunculated papules or tumors that are most commonly seen over the eyelids, neck, axillae, and groin. They are usually asymptomatic and are treated for cosmetic lesions. Metabolic syndrome (Met S) comprise of a cluster of risk factors of metabolic origin, which are accompanied by increased risk of cardiovascular disease and type-2 diabetes mellitus. To identify, the patients with skin tags and their positive relationship with Metabolic Syndrome, among the patients attending the Dermatology & Venereology department in a tertiary care teaching hospital. A pre-structured and pre-tested Proforma was used to collect data from 100 patients attending Dermatology outpatient department in a tertiary care teaching hospital. A total of 62% of the participants with skin tags had underlying metabolic syndrome. The proportion of people with metabolic syndrome gradually increased with increasing age. The association between age and metabolic syndrome was statistically significant (P value 0.002). Although there was no statistically significant association between gender and metabolic syndrome in study population. The proportion of people with Acanthosis. Nigricans gradually increased with increasing age. There was a statistically significant association between the skin tags and metabolic syndrome (P value < 0.016). We propose to consider skin tags as cutaneous findings frequently associated with the risk factors for Metabolic Syndrome and heart disease, and recommended that these patients should be carefully evaluated for Metabolic Syndrome and heart disease. Skin tag is an indicator of peripheral insulin resistance which may be an early marker of metabolic syndrome.