The aim of study was to assess genetic polymorphisms and serum level of chromogranin A (CgA) and its association with metabolic syndrome (MetS) components in the Fars ethnic group. Two hundred and forty-six people from Fars ethnic group participated in the study. The ATP III criteria were used to determine MetS components. The serum CgA level was measured by ELISA and the detection of the two regions were performed by TETRA ARMs-PCR and RFLPPCR methods. In results, the CC, CT, and TT genotypes of +87 C>T were 65%, 31.7%, and 3.2%, and were 74.8%, 25.2%, and 0% in subjects with and without MetS, respectively. The C and T alleles of +87 C>T were 81%, 19% and 79%, 21% in both groups, respectively. The TT, CT, and CC genotypes of -415 T>C were 76.4%, 21.1%, 2.4% and were 58.5%, 40.6% and 0.8% in subjects with and without MetS, respectively. The T and C alleles were 87% and 13% and 79% and 21% in both groups, respectively. There was correlation between serum level of fasting blood sugar (FBS) and CgA in subjects with MetS. We conclude that the increased CgA level in the subjects with MetS has a positive significant relationship with serum level of FBS. The most differences in CgA gene polymorphism were seen in -415 T>C genotype than that of +87C>T genotype when compared two groups. It may mean that subjects with MetS in the Fars ethnic group are more sensitive and greater risk for the development of MetS in the genotype of -415 T>C.