Introduction: Indonesia has a serious burden of cardiovascular disease, especially coronary heart disease (CHD). The prevalence of CHD has not in fact increased; however, there has been a significant increase in the prevalence of CHD risk factors. Several of these occurring together could cause metabolic syndrome, whose prevalence is relatively high in Indonesia, and consequently increase the risk of CHD. This study aims to obtain the risk of CHD in patients with metabolic syndrome in Indonesia. Methods: This is a retrospective cohort study with a median followed up of 6.8 years, secondary data from the Indonesian Family Life Survey (IFLS) waves 4 and 5 (2007-2014), and a study population of 6,571 respondents aged 40-69 years. The Joint Interim Statement criteria were used to define metabolic syndrome, with the omission of one component. Results: The prevalence of metabolic syndrome was 20%; the highest component was low HDL at 69.1%, followed by hypertension at 59.7%, and central obesity at 39.7%. The incidence of CHD was 2.72%, with an incidence rate 34per 100,000 person-years. Multivariate analysis found that the relative risk (RR) hazard ratio (HR) was 2.16 (95% CI 1.564-2.985). Conclusion: Subjects with metabolic syndrome had a two times higher risk of developing CHD, as adjusted by sex, age, smoking status, and physical activity.