Background: Metabolic syndrome (MetS) is an important public health concern associated with an increased risk for cardiovascular disease and type 2 diabetes. Despite its global significance, the prevalence of MetS in Azerbaijan is unknown. The purpose of this study was to examine the prevalence of MetS and its relation to physical activity (PA) and nutrition in a representative sample of Azerbaijani adults. Methods: The study included 288 adults (159 women and 129 men), 20 years of age and older, from Guba, Azerbaijan recruited between January and April 2016 by random sampling in line with gender and age distribution. Revised National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS and prevalence estimates of each individual component were determined. PA and food consumption were assessed with validated questionnaires. Results: Overall prevalence of MetS was 28.4%. Abdominal obesity was the most common individual component (49% and 85.4% in whole population and in those with MetS, respectively), and it was the only component more common in women than men in the whole population and among those with MetS (P < 0.05 for both). The odds ratio for having MetS was 0.56 (95% confidence interval, 0.34-0.95) in moderate-high PA group compared with low PA group, suggesting a reduced risk of MetS with increased PA. Food consumption did not show a difference in participants with and without MetS. Conclusions: MetS in Azerbaijan is common and associated with low PA. Preventive measures should be taken to address this public health problem and related risk factors in the country.