Early detection and interventions for metabolic syndrome (MetS) are the most cost-effective methods for preventing many chronic diseases. There have been discordant findings in various countries due to different genetics and lifestyles. The goal of this study was to investigate the association of MetS with parental diseases, a Chinese-style diet, and rural-urban regional differences with a large-scale epidemiological survey in Taiwan. Data were obtained from the Taiwanese Survey on Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH), a cross-sectional population-based study with multistage stratified random sampling conducted by the Taiwan Bureau of Health Promotion in 2002. Public health nurses visited homes to conduct the survey, including blood drawing and an interview. Multiple logistic regression analysis was used for exploring the factors associated with MetS. A total of 6591 people completed data for analysis. Our results revealed that older age, male sex, and maternal diabetes or hypertension, were significantly associated with MetS. Eating poultry with skin and fat and eating a bean-free diet may be associated with a higher risk of MetS. People who exercised regularly and the residents of the Taipei metropolitan area had a lower prevalence of MetS. As a result, people with maternal diabetes or hypertension should pay attention to their cardiovascular health and prevention of MetS. We suggest that eating skinless and low-fat poultry, eating more beans, and exercising regularly, may decrease the risk of MetS. We should make an effort to advocate for health promotion, including lifestyle modification, especially among the high-risk population and among residents in rural areas with limited medical resources.