 This study explores the relationship between liver involvement and arterial stiffness in individuals with metabolic syndrome, METS, a prominent global cause of chronic liver disease associated with cardiovascular risk factors. The results show that patients with METS have significantly higher liver involvement and vascular involvement, as well as a higher prevalence of metabolic syndrome components. A two-step clustering algorithm reveals the interplay between metabolic syndrome elements and typologies of hepatic steatosis and arterial stiffness degrees. The study advocates for a comprehensive diagnostic approach when METS or metabolic-associated steatotic liver disease, MSLD, is suspected.