BACKGROUND Certain dietary patterns have been associated with higher risk of noncommunicable diseases, with South Asians identified as a high-risk group. The present study aimed to identify the association between dietary patterns and the metabolic syndrome (MS) in South Asians living in the UK. METHODS Dietary patterns were derived by principal component analysis from 15 different food groups using an ethnic-specific food frequency questionnaire. MS risk factors, including obesity and hypertension, were measured, whereas existing conditions of dyslipidaemia and hyperglycaemia were self-reported. Participants (n = 100) were divided into quartiles based on dietary factor scores and the link between dietary patterns and risk factors was investigated. RESULTS Three different patterns were derived, which together explained 46% of the total diet variation; eastern pattern, mixed pattern and western pattern. An inverse correlation was found between the eastern pattern and education P = 0.05). A direct correlation was found between the western pattern and physical activity (P = 0.05) and the overall risk of MS (P = 0.05). Body composition was altered as residence time in the UK increased, with a reduction in muscle mass (29-26%) and an increase in body fat (31-37%). Diagnosis criteria for MS were found in 20% of the participants. CONCLUSIONS Dietary acculturation, including a reduction in vegetarianism, an increased intake of caffeinated drinks and altered meal patterns, may be associated with the higher prevalence of MS in migrant South Asians in the UK.