OBJECTIVES: The aim of the study was to examine the relationship between occupational stress and cardiovascular risk factors including metabolic syndrome in a working population. METHODS: A cross-sectional population-based survey was conducted among Koreans working in several industries. They were questioned about: demographic factors, marital status, education, personal history, alcohol intake, smoking, and physical activity , while their occupational stress was assessed using the Korean Occupational Stress Scale (KOSS). The subjects were measured for height, weight, blood pressure, waist circumference, fasting plasma glucose, cholesterol, triglycerides, HDL-cholesterol and LDLcholesterol. Regression analyses to determine the relationships between occupational stressors using KOSS and cardiovascular risk factors were performed using multivariate models with adjustment for potential confounders. RESULTS: A total of 2,097 workers (1,770 men and 327 women) were included. Multiple logistic regression analysis (socio-demographics and potential confounders) demonstrated a positive association between high interpersonal conflicts and hypertension, a negative association between high job insecurity and diabetes and no association between any KOSS subscale and metabolic syndrome and obesity. Multiple linear regression, adjusted for socio-demographics and potential confounders demonstrated a negative association between low HDL-cholesterol and poor physical environments, high job demand and poor job insecurity and no association between lipid profiles and other KOSS sub-scales. CONCLUSIONS: A few KOSS sub-scales such as interpersonal conflicts showed a positive association with hypertension in Korean workers. Neverthelsss, some measures of occupational stress showed a negative association with diabetes and HDL-cholesterol in cross-sectional population-based survey. We therefore decided to conclude this association by longitudinal study.