Introduction: Background: Metabolic syndrome is a major issue in patients treated with long-term antipsychotic medication and associated with increased cardiovascular morbidity as well as mortality. In the current study, we assessed its presence and risk factors in our population. Methods:A cross-sectional analysis of 370 subjects aged between 18 and 65 years who were treated with antipsychotics for at least year was performed. The obtained data included demographic data, psychiatric history and metabolic parameters. Metabolic syndrome was diagnosed according to the NCEP ATP III criteria. Risk factors were identified by bivariate and multivariable logistic regression analyses. Results: The occurrence rate of metabolic syndrome was 37.8%. The most prevalent component was raised waist circumference, affecting 51.9% of the population, followed by low HDL cholesterol at 48.1% and elevated triglycerides at 44.1%. Olanzapine exhibited the highest occurrence rate of metabolic syndrome (47.8%), whilst aripiprazole demonstrated the lowest frequency (27.0%). The age (adjusted odds ratio [AOR] 1.03, 95% confidence interval [CI] 1.01-1.05) and length of antipsychotic usage (AOR 1.07, 95% CI 1.03-1.11) were found to be significant predictors. Olanzapine was found to have a considerably increased likelihood of causing metabolic syndrome compared to aripiprazole, with an adjusted odds ratio (AOR) of 2.41 and a 95% confidence interval (CI) of 1.22-4.76. Conclusion:This study demonstrated the significant frequency of metabolic syndrome among patients taking long-term antipsychotic medications and identified age, duration of treatment, and antipsychotic type as key risk factors. These findings highlight the importance of regular metabolic monitoring, personalised therapy selection, and integrated therapies for managing metabolic risks in this sensitive population.