The metabolic syndrome (MetS) is one of the most frequent reasons for the higher mortality in patients with schizophrenia. It is difficult to separate between effects of medication or the disorder itself on the development of MetS. In the present study, patients at clinical high risk for first-episode psychosis (CHR) were examined and the prevalence of the MetS was assessed. One hundred and sixty-three unmedicated antipsychotic naïve CHR patients aged between 18 and 42 years and suffering from unmanifested prodromal symptoms were compared to 35,869 patients of the “German Metabolic and Cardiovascular Risk Study” (GEMCAS). We observed a slightly higher prevalence of single MetS criteria in CHR group compared to the GEMCAS sample, in particular: high blood pressure (35.0 vs. 28.0%), waist circumference (17.6 vs. 15.1%), and high fasting blood glucose (9.4 vs. 4.0%). We assume the higher risk for MetS in schizophrenia patients or CHR patients to derive from genetic factors.