This study aims to evaluate the effect of Acarbose on HbA1C and lipid profile in patients with metabolic syndrome in a tertiary care hospital in North India. Metabolic syndrome is a cluster of risk factors including abdominal obesity, insulin resistance, hypertension, dyslipidemia and impaired glucose metabolism, all of which increase the risk of type 2 diabetes and cardiovascular disease. Acarbose, an alpha glucosidase inhibitor, lowers postprandial hyperglycemia by delaying carbohydrate absorption and has also shown potential benefits in improving triglyceride and lipid levels. The primary objective is to assess changes in HbA1C, triglycerides, and non HDL cholesterol after 12 weeks of acarbose therapy, along with reversal of metabolic syndrome criteria. This randomized controlled trial will be conducted over 12 weeks on 274 patients at GSVM Medical College, Kanpur, between october 2025 and march 2026. Eligible participants are adults aged 30 to 65 years who meet at least three criteria for metabolic syndrome, either newly diagnosed or on stable oral antidiabetic agent with or without a single antihypertensive. Patients with hepatic disease, gastrointestinal disorders, severe renal impairment, insulin therapy, pregnancy, lactation, or recent acarbose use will be excluded. Participants will be divided into two groups that is Group A will receive acarbose and the standard of care, and Group B will receive only the standard of care. Baseline and follow-up assessments will include waist circumference, BMI, blood pressure, HbA1c, and lipid profile. Data will be analyzed using SPSS software, with statistical significance set at p less than 0.05.