Background: Cardiopulmonary symptoms (CPS) may possibly reinforce the effect of metabolic syndrome (MetS) or vice versa. However, there is scanty data on the possible association between MetS and  symptoms such as easy fatigability, chest pain, shortness of breath and heart disease among Black adolescents in sub-Sahara Africa Objective: Metabolic syndrome is recognized as a cluster of three of five risk factors including obesity, hypertension, abnormally high levels of  triglyceride (TG), dyslipidemia (abnormally high concentrations of total cholesterol (TC), low-density lipoprotein (LDL) and an abnormally low level of high-density lipoprotein (HDL) and hyperglycemia. Its association with cardio-pulmonary symptoms is not well documented. There is dearth of scientific data focusing on MetS and its association with cardio-pulmonary symptoms among adolescents in sub-Saharan populations. This study, therefore, aimed at determining the prevalence and possible association of MetS and CPS among Black adolescents  living in Lagos, Nigeria Research design and methods: Six hundred and thirteen Secondary school students (age range: 10–19 years, both sexes) were recruited into this cross-sectional study, epidemiological. In addition to questionnaires which included cardio-pulmonary symptoms that were administered, anthropometric measurements (weight in kilograms, height, and waist circumferences in centimeters) were measured for each student. Fasting venous blood was aseptically collected and preserved for lipid profile and blood glucose assessments. Systolic and diastolic blood pressures were taken. MetS was assessed using appropriate diagnostic criteria for adolescents. NCSS 22 software was used for data analysis.                                                                 Results: A total of 613 Secondary School students aged between 10 and 19 years (mean (±sd) age:14.7 (2.1) yrs. were included. The BMI (Kg/m2) of girls was significantly higher (t-test=-2.22, P-value=0.03) than that of boys. Though overweigh/obese students were significantly younger (t-test=4.02, P-value=0.0002), their systolic blood pressure was significantly higher (t-test=-3.32, P-value=0.002) than that of lean subjects. Girl’s waist circumference status  (χ²=7.13, P-value=0.008) and high systolic blood pressure (χ²=8.00, P-value=0.005) were significantly higher among girls than among boys. Height (cm) (t-test = -2.03, P-value =0.047), weight (kg) t-test = -3.78, P-value = 0.0004), BMI (kg/m2) (t-test = -3.51, P-value = 0.0008), BMI-for-age percentile (t-test=-4.37, P-value = 0.00005) and waist circumference (t-test = -3.45, P-value = 0.001) were significantly higher in those with, than those without MetS. Pearson’s correlation coefficient  only shows strong association with MetS among study subjects with shortness of breath (r = 0.12, t = 3.01, P-value = 0.003, 95% CI: -0.04, 0.20). Girls who were easily fatigued were 1.27 times more likely to have MetS, whereas girls with chest pain (OR= 0.83, 95% CI=0.31, 2.19), shortness of breath  (OR= 0.33, 95% CI=0.09, 1.15). The mean SBP of study participants with MetS who were easy fatigued was significantly higher (t-test=-2.51, P-value=0.02) than that of participants without MetS.                                              Conclusion: The study agrees that preventing the escalating burden of blood lipid and glucose abnormalities among Nigerian secondary school students is essential. Shortness of breath, which may be a precursor of hypertension, diabetes, and coronary heart disease, was significantly associated with MetS. Therefore, governments at Federal and State levels should consider appropriate interventions to curtail these early onset morbidities among adolescents. Clinicians should also be aware of them.