Metabolic Syndrome (MS) is defined as a constellation of cardiometabolic risk factors that are associated with an increased risk of Cardiovascular Disease (CVD) and type 2 diabetes (T2D). T2D and CVD affect increasing number of young and social active people, so that the prevention of these diseases is a strategical aim of health systems all over the world. Metformin is one of the main therapeutic options in the polycystic ovary syndrome, which landmarks are insulin resistance and hyperinsulinaemia defining higher incidence of MS and increased cardiovascular risk. It n is established like a first step therapy of T2D, because it targets insulin resistance and hyperinsulinaemia and fulfills the treatment goals-a good glycaemic control and a reduction of cardiometabolic risk. It is the only antidiabetic medication that has improved prognosis like a primary end point in the randomized controlled trial (UKPDS). Metformin reduces the incidence of T2D and CVD risk factors in individuals with impaired fasting blood glucose and impaired glucose tolerance. Having in mind, the protective cardiometabolic effects of metformin beyond glycaemic control, the research and clinical interest is pointed at its implication in individuals with normal glucose tolerance at high risk for development of T2D and CVD.