Backgrounds: In 2005, the International Diabetes Foundation (IDF) published a new criteria that modified the ATP III definition of metabolic syndrome(MetS). But, there is little information available about the prevalence of MetS and its association with coronary artery disease(CAD) based on the IDF criteria. Therefore, we compared the risk of coronary artery disease (CAD) in Korean population according to the different MetS criteria.[the Asian-modified NCEP criteria (a-NCEP), the Korean-modified NCEP (k-NCEP) criteria, the Asian-modified IDF criteria (a-IDF), and the Korean-modified IDF (k-IDF)]. Methods: A total of 3852 non diabetic subjects were enrolled in the cardiovascular genome center. We applied the 4 different criteria of MetS in this population to assess the risk of CAD according to each criteria. Results: The prevalence of a-NCEP, k-NCEP, a-IDF and k-IDF were 1395 (36.2%), 1276 (33.1%), 1213 (31.5%) and 1020 (26.5%) respectively. Odds ratio (OR) of CAD in each criteria of MetS were as follows: (OR: 1.57, 95% CI, 1.29 – 1.89, p< 0.001) in a-NCEP, (OR: 1.57, 95% CI, 1.30 – 1.89, p<0.001) in k-NCEP, (OR: 1.67, 95% CI, 1.38 – 2.04, p < 0.001) in a-IDF and (OR: 1.70, 95% CI, 1.40– 2.07, p<0.001] in k-IDF. Conclusion: The IDF criteria conferred lower prevalence of metabolic syndrome but was related to the higher risk of CAD when compared to the NCEP criteria. Therefore we conclude that IDF criteria may be a better predictor of CAD than NCEP criteria in this group of patients. However, the application of the Korean modified criteria was associated with lower prevalence of metabolic syndrome with similar predictive value of CAD when compared to the Asian modified criteria.