Background: Changes in lifestyle such as change in diet and physical inactivity have increased the risk of developing metabolic syndrome. The role of diet composition in the etiology of metabolic syndrome has not been studied thoroughly and few observational studies in Iran were conducted in this regard. The aim of the present study was to determine the association between dietary carbohydrate intake and the prevalence of metabolic syndrome. Methods: We searched PubMed databases using metabolic syndrome, carbohydrate, dietary carbohydrate scores, whole grain, and refined grain as keywords. Cross-sectional, clinical trial, and prospective cohort studies were included in this review. Findings: Based on previous studies, an inverse association exists between whole grain intake and components of metabolic syndrome such as abdominal obesity, insulin sensitivity, and dyslipidemia. Moreover, refined-grain intake is positively associated with the prevalence of metabolic syndrome. A positive association was also observed between the percentage of carbohydrate and fat to total energy intake and increased risk of metabolic syndrome. Conclusion: The inverse association between whole grain intake and metabolic syndrome indicated the protective effect of constituents of whole grain. Subjects with higher intake of carbohydrate or fat exhibited a higher risk of developing metabolic syndrome. Recommendations to reduce glycemic load in diet and using whole grains, fruits and vegetables, and vegetable sources of fat and protein instead of refined carbohydrates may reduce the risk of chronic diseases including obesity, metabolic syndrome, diabetes, and cardiovascular diseases.