Abstract: Metabolic syndrome (MetS) prevalence is greedily increasing; fortunately, managing determinants of unhealthy intake, inactivity, obesity, hypertension, and hyperlipidemia can reverse the problem. Purpose: To evaluate effect of managing metabolic syndrome on reversing selected determinants among patients with metabolic syndrome. Methods: A purposive sample of 100 patients were selected. Setting: Medical and diabetic out-patients' clinics in Menoufia University Hospital, Egypt. Design: A quasi-experimental design was utilized. Instruments: Five instruments were used including: characteristics of patients structured interviewing questionnaire, food frequency questionnaire, international physical activity questionnaire short form, self-reported compliance sheet, and metabolic syndrome determinants' diagnostic evaluation sheet. Results: Intake of coffee, fat, sweets, and processed meat was reduced from 42%, 43%, 46%, and 60% preintervention to 6%, 10%, 14%, and 5%, respectively, postintervention, by six months. patient's percent who practiced physical activity and walking preintervention were 6% and 3%, then increased to 86% and 49%, respectively, postintervention by six months. Moreover, triglycerides and fasting blood glucose were reduced from 74% and 42% pre-intervention to 3% and 14%, respectively, six months post-intervention. Conclusions: Managing metabolic syndrome determinants helped the patients to be more physically active, eat healthier foods, reduce their waist circumferences, blood triglyceride, low-density lipoprotein, and total cholesterol, and smoke fewer cigarettes each day. They also maintained regular laboratory check-ups, with physiological measurements monitored. This eliminated the three modifiable MetS determinants, and patients became with two instead of five MetS determinants. Recommendation: Determinants management should be applied to all patients with metabolic syndrome, utilizing this the study steps.