The objective of our study was to compare the health status of the Roma people with that of the general population in Hungary. A health examination survey to define the prevalence of metabolic syndrome and its components was performed in a representative random sample (n = 646) of the Roma population aged 20-64 years living in segregated colonies, and data were compared with that obtained in a representative random sample (n = 1819) of the Hungarian population. The risks for central obesity, hypertension and raised triglyceride level among Roma adults were not different from the Hungarian references, while raised fasting plasma glucose or known type 2 diabetes mellitus (OR = 2.65, 95%CI 1.90-3.69), reduced HDL cholesterol level or treated lipid disorder (OR = 2.15, 95%CI 1.65-2.79) were significantly more frequent in all age groups in the Roma sample. The prevalence of metabolic syndrome (OR = 1.37, 95%CI 1.03-1.83) was also significantly higher among Roma than in the general Hungarian population. Besides tackling the socio-economic determinants of the poor health of Roma people, specific public health interventions considering increased genetic susceptibility to metabolic disturbances are needed to improve their health status.