OBJECTIVES: The association between chronic hepatitis B (CHB) infection and metabolic syndrome (MetS) remains inconclusive. This study examined the association between CHB infection and MetS among adults in the United States with recent data and adjustments for a comprehensive set of risk factors. METHODS:  Adults aged 18 years or older who were clinically assessed for Hepatitis B and MetS from the National Health and Nutrition Examination Survey (NHANES) 2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012 cycles were included in the study (n=29,906). MetS was defined according to the NCEP/ATP III guidelines. CHB was identified by the seropositivity of Hepatitis B surface antigen and core antibody in the absence of Hepatitis B surface antibody. Statistical analyses included chi-square tests and logistic regressions. RESULTS: A lower proportion of adults with CHB reported MetS as compared to adults without CHB (9.6% vs. 18.6%, p= 0.037). In adjusted analyses, adults with CHB were less likely to report MetS compared to those without CHB with an adjusted odds ratio (AOR) of 0.12 and 95% CI: (0.02-0.85). When analyzed by individual components of MetS, high waist circumference (AOR = 0.10, 95% CI: 0.03-0.41) and dyslipidemia (AOR = 0.42, 95% CI: 0.21-0.84) were less likely among those with CHB compared to no CHB. No association between CHB and other metabolic components were found. CONCLUSIONS: A significantly inverse association between CHB and MetS was found in the study. Future studies need to explore the underlying mechanisms of the observed associations.