Background: Metabolic syndrome (MS) could cause sudden incapacitation among pilots in Indonesia.The aim of this study was to identify risk factors of MS among short-haul commercial pilots in Indonesia.Methods: A cross-sectional study with purposive sampling was conducted among commercial pilotstaking medical examination at the Civil Aviation Medical Center, Jakarta from July 27-August 30th,2014. Metabolic syndrome was assessed according to the National Cholesterol Education Program AdultTreatment panel III criteria and criteria. Risk factors were collected using anonymous self-reportingquestionnaire. The laboratory data were extracted from medical records. Cox regression was used toidentify dominant risk factors of MS.Results: During data collection, 2135 pilots taking medical examination, Total male Asian pilots metthe inclusion criteria was 864 pilots. Prevalence of MS was 18.28%. Compared to 20-35 year-old group,subjects aged 56-65 years-old had 88% higher risk for MS [adjusted relative risk (RRa) = 1.88; P = 0.019].In term of number of sectors in the last 24 hours, compared to 0-3 sectors, subjects who had 6-7 sectors inthe last 24 hours had 66% higher risk for MS (RRa = 1.66; P = 0.033), while subjects who had 8 or moresectors in 24 hours had 82% more risk for MS (RRa = 1.82; P = 0.072).Conclusions: The pilot aged 56-65 years-old, who had 6 or more sectors in the last 24 hours, had higherrisk for metabolic syndrome among short-haul commercial pilots in Indonesia. (Health Science Journalof Indonesia 2015;6:81-6)