PURPOSE/HYPOTHESIS: People living with HIV (PLWH) are at an increased risk of developing metabolic syndrome (MetS) as a consequence of the virus itself and antiretroviral medications. The purpose of this investigation was to characterize the cardiometabolic profile of PLWH and their risk of MetS. We hypothesized that the vast majority of PLWH would have 3 or more of the markers for MetS based on the World Health Organization (WHO) criteria. NUMBER OF SUBJECTS: 200 PLWH in the South Texas Region MATERIALS AND METHODS: A large dataset from electronic medical records (EMR) of PLWH seeking care at The University of Texas Health San Antonio and affiliates was used for this investigation. We identified from the EMR documented markers for MetS to characterize the cardiometabolic profile of PLWH in this region. The variables considered to meet the diagnosis of MetS per WHO were: cholesterol (≥ 200 mg/dL), triglycerides (TG) (≥150 mg/dL), glucose (≥ 6.5%), body mass index (≥30 kg/m2), and blood pressure (SBP ≥ 140 mmHg / DBP ≥ 90 mmHg). Demographic variables retrieved from the EMR were: height (in), weight (lbs), age (yrs), gender (M/F), race, viral load (copies/mL), and CD4 (%). We identified the first encounter as representation of the initiation of care. A reduced database was created in Microsoft Excel to represent our variables of interest and transferred to the statistical software (SPSS, IBM v.26) for analysis. The database was screened for absurd values and was considered missing values if found. Descriptive statistics such as mean, standard deviation (SD), range, variance, minimum and maximum, and percentiles (25, 50, 75) were estimated for all variables. RESULTS: The sample comprised of 35% Hispanics and 65% Non-Hispanics, primarily Caucasians (75%) and Black (19%), of which 77% classified themselves as men. Age, weight, and height were 49.88 ± 12.2 yrs; 179.1 ± 44.3 lbs; 77.4 ± 3.8 in, respectively. CD4 and viral load were 20.8 ± 10.5 % and 27,102 ± 102,813 copies/mL, respectively. The average cardiometabolic profile of these individuals was borderline for meeting the criteria for MetS; BMI=29.5 ± 7.4 kg/m2 (range: 21-53); HbA1C=6.17 ± 1.84% (range: 4-13); cholesterol=177 ± 42.7 mg/dL (range: 80-362); TG=190 ± 156.1 mg/dL (range: 37-1,099); SBP= 129.9 ± 17.2 mmHg (range: 92-187); DBP=78.2 ± 11.8 mmHg (range: 52-117). However, by evaluating the range of values of the sample close to 50% of PLWH met the criteria for MetS in at least 3 of the markers. CONCLUSIONS: PLWH in the South Texas region exhibit an elevated cardiometabolic profile compatible with MetS.