Metabolic syndrome is a clinical syndrome characterized by abdominal obesity, insulin resistance, hypertension and dyslipidemia. It not only increases the risk of cardiovascular disease but is also closely associated with the development of various chronic diseases. The abnormal accumulation and metabolic activity of visceral fat are significantly linked to the onset of metabolic syndrome and its related complications. An effective assessment of visceral fat is essential for the early identification of metabolic syndrome and its risk of related complications. As a new indicator to evaluate visceral fat, the metabolic score for visceral fat combined with insulin resistance, anthropometric and demographic factors can effectively evaluate visceral fat content, and has better predictive ability than traditional obesity indicators for metabolic syndrome, diabetes, hypertension, cardiovascular events, etc. This article reviews the progress of metabolic score of visceral fat and metabolic syndrome and its related complications.