Objective: The aim of this study was to investigate the effect of MetS in pathogenesis of ejaculatory symptoms, particularly PE. In addition, we evaluate the other risk factors associated with PE. Design and Method: Between January 2010 and July 2014, we analyzed the medical records of men who had visited to our Urology clinic for screening of male health. To evaluate the risk factors including MetS for PE, patients were assessed self-reported intravaginal ejaculation latency time (IELT), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), the Male Sexual Health Questionnaire (MSHQ-EjD) for Ejaculatory Dysfunction, NIHChronic Prostatitis Symptom Index (NIH-CPSI), and Androgen Deficiency in the Aging Male (ADAM) scales. Premature ejaculation defined as self-reported IELT <1 minute, and metabolic syndrome diagnosed by modified National Cholesterol Education Program’s Third Adult Treatment Panel (NCEP ATP III) criteria. Results: Among the total of 1029 men, 74 patients (7.2%) were considered to have PE (ejaculation within 1 min) and 111 patients (10.8%) were considered to have MetS. The multivariate logistic regression analysis showed that IIEF OS score (OR 0.670, P <0.001), NIH-CPSI pain score (OR 1.070, P = 0.048), NIH-CPSI voiding score (OR 1.167, P = 0.040), and metabolic syndrome (OR 2.187, P = 0.023) were significantly related to the prevalence of PE. Conclusions: MetS may be an important predisposing factor for the development of PE, and consequently its effective prevention and treatment could also be important for the prevention of PE.