Background: Skin inflammation caused by the immune system that affects the extensor surfaces of the extremities, sacrum, and scalp is called psoriasis. It affects between 2% and 4% of the world's population. Several clinical subtypes exist. When it comes to impact less than 10% of the body surface area (BSA), it might be either localised or generalised. Obesity, diabetes mellitus, metabolic syndrome, and cardiovascular disease have been linked to it. The first-line anti-diabetic drug metformin is used to treat type 2 diabetes mellitus (T2DM) in addition to its favorable effects on lipid profiles, weight loss, cardiovascular risk, and hyperinsulinemia in those patients. When AMP-activated protein kinase (AMPK), an enzyme involved in the anti-inflammatory response, is activated, dendritic cells and T cells are reduced and T-cell activation is reduced as well, all of which lead to the inhibition of cell proliferation and the improvement of symptoms associated with the skin condition known as "psoriasis." Objective: This review article aimed toassess the role of metformin as an adjuvant therapy to methotrexate in the treatment of generalized psoriasis. Methods: The databases were searched for articles published in English in 3 data bases [PubMed – Google scholar - Science direct] and Boolean operators (and, or, not) had been used such as [Metformin or, methotrexate, metabolic syndrome and psoriasis] and in peer-reviewed articles between August 2003 and March 2021. Conclusion: Metformin and methotrexate may enhance psoriasis patients' clinical results by improving metabolic syndrome parameters due to their antiproliferative and anti-inflammatory actions.