This study examines the relationship between adherence to different dietary patterns and the presence of metabolic syndrome and its components among Korean adults. The sample consisted of 406 Korean adults aged 22 to 78 years recruited from hospitals. Metabolic syndrome was defined according to the criteria issued by the Adult Treatment Panel III, with the exception of central obesity, which was defined according to the Asian-Pacific criteria. Dietary information was obtained by means of a 24-hour recall and a 3-day food record, and factor analysis was used to define dietary patterns. Factor analysis identified 4 major dietary patterns, which explained 28.8% of the total variance, based on the percentage of total daily energy intake from each food group: Korean traditional, alcohol and meats, sweets and fast foods, and fruit and dairy. After controlling for all potential confounders, we found that the Korean traditional dietary pattern was not associated with individual components of the metabolic syndrome but was significantly associated with increased odds of having metabolic syndrome. The fruit and dairy pattern was significantly associated with decreased odds of impaired blood glucose, hypertriglyceridemia, and metabolic syndrome. Our findings suggest that the fruit and dairy pattern is associated with reduced risk of having metabolic syndrome.