Steffes, GD, Megura, AE, Adams, J, Claytor, RP, Ward, RM, Horn, TS, and Potteiger, JA. Prevalence of metabolic syndrome risk factors in high school and NCAA Division I football players. J Strength Cond Res 27(7): 1749–1757, 2013—Metabolic syndrome (MetSyn) is a clustering of metabolic and cardiovascular disease risk factors. The purpose of this study was to determine the prevalence of MetSyn risk factors in high school (HS) and college (College) football players and to examine if the prevalence varied according to body fat percent (%Fat). One hundred twenty-three males (height 179.0 ± 6.7 cm; weight 89.4 ± 19.6 kg) from 7 different high schools and 82 males (height 186.2 ± 6.8 cm; weight 99.6 ± 16.8 kg) from one university participated. All testing occurred in the early morning after an overnight fast. %Fat, waist circumference, resting systolic and diastolic blood pressure, fasting triglyceride, high-density lipoprotein (HDL) cholesterol, and blood glucose were determined using standard testing procedures. The MetSyn risk factor levels were determined using American Heart Association criteria. Subjects were grouped by position and playing level (HS, College). Independent t-tests, chi-square analysis, 2-way analysis of variance, and path analytic models were used in the statistical analysis. Significance was set at p < 0.05. 6.8% (n = 14) of the sample met the American Heart Association criteria for MetSyn. Offensive and defensive linemen accounted for 92.3% of the players meeting MetSyn criteria with each playing level (HS, College) having 7 subjects. The MetSyn criteria differed significantly across %Fat. Obese players were more likely to meet the criteria for MetSyn. %Fat was a statistically significant predictor of mean arterial blood pressure, HDL cholesterol, and waist circumference. The MetSyn exists in both HS- and College-level football players, with almost all cases occurring in the athletes with the highest levels of %Fat (offensive/defensive lineman). Strength and conditioning coaches should be aware of the prevalence of MetSyn risk factors in offensive and defensive linemen and take appropriate actions to ensure athlete safety.