The purpose of this study was to assess clustering of Metabolic Syndrome components in aged Slovaks, and to investigate whether insertion/deletion (I/D) polymorphism of the human angiotensin-converting enzyme (ACE) gene is associated with this syndrome. Data were available from 374 Slovak participants (200 females and 174 males) ranging in age between 60 and 90 years. ACE I/D polymorphism was determined by PCR amplification of the ACE gene sequence. Metabolic Syndrome was diagnosed according to criteria in the NCEP ATP-III. Elderly males and females differ significantly in the prevalence of Metabolic Syndrome (females 45.1%, males 24.8%). The males and females including subjects with and without metabolic syndrome, respectively, did not differ significantly in the three genotype distributions (p = 0.603 and p = 0.247). The allele frequencies (D = 0.5483, I = 0.4517) in the entire sample fell within the Hardy-Weinberg equilibrium. There was no confirmed association between ACE genotype and phenotypic variation in the recognized risk components for Metabolic Syndrome in elderly Slovaks. Among other factors which may induce a difference in Metabolic Syndrome, significant effect was detected for sex, BMI, HDL, TG, glucose and the ApoB/ApoA1 ratio.