Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities which include visceral obesity, insulin resistance, raised blood pressure (BP), hypertriglyceridemia, low high-density lipoprotein (HDL), hypercholesterolemia and impaired fasting plasma glucose (FPG).Uric Acid (UA) is the metabolic end product of purine metabolism in humans. Patients with hyperuricemia are at increased risk of renal, cardiovascular disease (CVD) events and vascular damage. Now there is evidence to suggest that urate-lowering treatment may reduce CVD risk. Cardiovascular disease is the leading cause of death in India. CVD related death rate in India is 272 per 1 lakh population which is higher than world incidence which is 235 per 1lakh. Uric acid is an independent risk factor and marker for atherosclerosis. It causes atherosclerosis by increased cytokine release leading to endothelial dysfunction through inactivation of Nitric oxide and suppression of endothelial cell proliferation. Aim: To find out the association of the uric acid level in the development of atherosclerosis in elderly subjects with metabolic syndrome and in elderly subjects without metabolic syndrome. Materials and methods:100 outpatients in the age group above 60yrs were selected. 5ml of Blood samples were taken for fasting blood sugar, blood cholesterol and serum uric acid. BMI was measured using their height and weight. Carotid artery thickness was measured by ultra-sonogram. Results were statistically analysed by using SPSS software. Results: In subjects with metabolic syndrome incidence of atherosclerosis is increased when uric acid level is increased. And it was observed that there was a statistically significant relationship in patients without metabolic syndrome (p value <0.001). Conclusion: Uric acid is found to be a risk factor for CVD independent of metabolic syndrome status.