Metabolic syndrome (MetS) characterized by obesity, hypertension, dyslipidemia, and insulin resistance is emerging as a critical health concern in India. In this study, bio-social determinants of MetS are assessed across five geo-climatic regions of West Bengal to determine environmental and socio-economic risk to regional MetS. This cross-sectional study included 1148 adults proportionally selected from each geo-climatic zone. Variables assessed included body composition, blood pressure, fasting glucose, and lipid profile, in addition to socio-demographic variables such as dietary patterns, physical activity levels, and family income. Using a combination of logistic regression, multivariate analysis of variance (MANOVA), and factor analysis, this study examined the interplay between geo-climatic conditions, lifestyle factors, and prevalence of MetS. The prevalence of MetS was found to be statistically significantly different among regions; it ranged from 16% in the hill region, 21% in the plateau, 27% in the plain, 21% in the delta, and 23% in the coastal region. Logistic regression analysis showed region and physical inactivity as major predictors of MetS. MANOVA disclosed regional differences in mean scores concerning obesity, hypertension, and lipid levels. Moreover, factor analysis disclosed clusters representing obesity, dyslipidemia, and hypertension. Such findings jointly influence geo-climatic factors and socio-economic conditions on the components of MetS. It is in that sense a bio-social understanding of MetS risk as it enhances the application of intervention strategies aimed at controlling and reducing metabolic syndrome prevalence levels across various Indian regions.