Metabolic syndrome (MetS) and andrological diseases share common risk factors and common patho-physiological mechanism. In this brief review we describe the relation between metabolic syndrome and male sexual disorders, and we explore the available evidence of the pathophysiological mechanisms correlating these conditions. The aim of this study was to describe the relation between metabolic syndrome and andrological diseases. Current literature shows strong evidence on the association between pathophysiological mechanisms linking metabolic syndrome and andro-urological diseases, such as premature ejaculation, erectile dysfunction, and hypogonadism. Strong associations are seen between male sexual dysfunction and central obesity, poor glycemic control, hyperlipidemia, as well as hypertension. The constellation of risk factors leading to metabolic syndrome are linked to male sexual dysfunction and are largely modifiable. Therefore, effective interventions targeting the underlying pathophysiology have the potential to greatly impact and improve patient sexual function and, ultimately, quality of life.