Stroke is one of the leading causes of death in the United States and worldwide. Metabolic syndrome, comprising abdominal obesity, elevated triglyceride levels, low levels of high-density lipoprotein cholesterol, elevated blood pressure, and impaired glucose metabolism, greatly increases the risk of cardiovascular disease, including stroke. The high prevalence of metabolic syndrome among individuals who experience stroke makes the metabolic syndrome a target for aggressive intervention and therapy. In addition to lifestyle changes, therapy with statins, angiotensin-converting enzyme inhibitors, insulin sensitizers, and antithrombotic agents to aggressively treat elements of metabolic syndrome is warranted. Statins favorably affect both lipid and nonlipid risk factors for stroke, making them a useful tool for stroke prevention.