The WHO ranked depression as the third-leading cause of burden of disease worldwide and projected that the disease will rank first by 2030. Depression is associated with higher prevalence of many somatic disorders, such as metabolic, cardiovascular and autoimmune diseases. Moreover, elderly with an impaired metabolic status, such as obesity or insulin resistance, who are strongly associated with the pre-diabetic stage, suffer more frequently from depression. Through more research studies, the relationship between metabolic syndrome and depression has been noticed primarily among elderly. More studies proved evidence that the pathogenesis of depression and metabolic syndrome includes endocrine and immune system, inflammatory response, activation of Hypothalamic Pituitary Axis. As the clinical treatment of depression is limited, exploring the co morbidity of depression and metabolic syndrome helps to identify new treatment strategies and further reduce the morbidity and mortality rate of depression among elderly. Depression may cause significant changes in elderly life which includes clinical mortality, decreased life span, diminished daily activity and loss of quality of life. The present review aims to analyze data on association between depression and metabolic syndrome in elderly. Methods Database searches were performed in Medline, Pubmed and PsycINFO for assessing the association between depression and metabolic syndrome in elderly. Results Current available data in the literature concerning the impact of Metabolic Syndrome on depression among elderly based on inconsistent evidence. Components of metabolic syndrome and factors associated with depression may show differential findings based on age, therefore larger quality studies are still needed in the field.