In light of recent findings on the association between insulin resistance and the development of colorectal malignancies, it is worthwhile to investigate whether metabolic syndrome (MS) is correlated to an increased number of colorectal neoplasms. However, few studies have been performed regarding the relationship between MS, colorectal adenomatous polyps, and cancer in Western or European countries. With this study, we aimed to investigate the association between MS and colorectal neoplasms in a Portuguese population.