Metabolic syndrome (MetS) is a cluster of risk factors that significantly increases the risk of cardiovascular disease. The lack of universally accepted diagnosis criteria makes it difficult to know the real prevalence of MetS in both adult and pediatric population. Lifestyle, especially nutritional habits and physical activity, have been suggested to be independent risk factors for the development of MetS. Recent studies highlight the need to prioritize overall dietary patterns, rather than isolated nutrients, to better appraise the associations between nutritional habits and MetS. In this review we summarize recently published intervention trials and systematic reviews that evaluated the association between overall dietary patterns and the risk of MetS. Westernized dietary patterns, characterized by a high consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages, which provide high amounts of saturated fatty acids and simple carbohydrates as added sugars, have been associated with higher risk of MetS. In contrast, more traditional dietary patterns, including the Mediterranean dietary pattern (MDP), characterized by a high consumption of vegetables, fruits, whole cereals and fish are associated with a reduced risk of MetS. The main characteristics of the MDP include a high consumption of nuts and olive oil, resulting in a relatively fat-rich pattern that provides high amounts of mono- and polyunsaturated fatty acids, bioactive polyphenols and dietary fiber. Strong evidence is accumulating to support that a closer conformity with the MDP is inversely associated with the incidence of MetS, cardiovascular risk factors, diabetes and cardiovascular disease.