The rising prevalence of cardiometabolic diseases is a worldwide problem, including Singapore. In 2010, the prevalence of obesity and type 2 diabetes mellitus (T2DM) had risen to 10.8% and 11.6% respectively. In 2009, of the 17,101 deaths (100%), ischaemic heart disease, cerebrovascular disease, and diabetes mellitus contributed respectively 19.2%, 8%, and 1.7% - making a total of 28.9% from cardiometabolic deaths. Cardiometabolic risk may be defined as a continuum of risks ranging from behaviour related factors, on to high risk diseases of the deadly quartet (hypertension, diabetes, hyperlipidemia, and obesity), and cardiovascular and metabolic endpoints. The pathophysicolgical basis of cardiometabolic risk is complex. The mechanisms responsible for the cardiometabolic syndrome are not entirely known, but it is likely that multi-organ insulin resistance, which is a common feature of the cardiometabolic syndrome, is involved. Low grade inflammation and dysfunction of high-density lipoprotein and its apolipoproteins are main drivers of cardiometabolic risk. Population studies in China and India provide insights on the development of cardiometabolic disease. PCOS, erectile dysfunction, antipsychotic medications related weight gain need to be addressed too as cardiometabolic problems. Interventions to reduce cardiometabolic risk include: health behaviour modification, pharmacological and surgical interventions, and avoidance of over-consumption of fructose sweetened beverages.