Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is associated with diabetes mellitus and cardiovascular disease. Lifestyle interventions applied to people with MetS has considerable beneficial effects on disease preventive outcomes. This study aimed to examine the effects of 1-year of yoga exercise on the cardiovascular risk factors including central obesity, hypertension, dyslipidemia and hyperglycemia in middle-aged and older Hong Kong Chinese adults with MetS.