The enormous impact of the metabolic syndrome on public health, and the exciting progress made in research into this field recently, led to the organization of the ‘1st International Congress on Prediabetes and the Metabolic Syndrome’ in Berlin, Germany in April 2005. The congress was dedicated to the recent advances in this field and served as a much-needed platform for the presentation and evaluation of concepts in the aetiology of the metabolic syndrome, and current screening and intervention efforts. Pesach Segal and Paul Zimmet report on the meeting, which brought together almost 2500 delegates – scientists, clinicians and industry – from 85 countries.