Background: Elevated postprandial inflammation accelerates the process of systemic inflammation involved in chronic diseases. It seems that inflammation promotes the risk of cardiovascular disease and metabolic syndrome (MetS) independent from the effect of blood lipids. Dietary macronutrient composition has been suggested as one of the most important determinants of inflammation in the MetS. This study aimed to review the current evidence on the effect of dietary macronutrients on postprandial inflammation in the MetS.Methods: We searched PubMed/Medline from 1970 until 2011 with macronutrient, high/lowcarbohydrate, -fat, -protein meal, postprandial/acute inflammation, endothelial function, metabolic syndrome and individual inflammatory biomarkers as keywords. The cross-sectional and prospective studies as well as clinical trials were included in this investigation.Findings: Consumption of all dietary macronutrients, particularly dietary carbohydrates, was associated with elevated levels of postprandial inflammation in both healthy and unhealthy subjects. Carbohydrates have been consistently shown to induce postprandial inflammatory response as well as oxidative stress. Consumption of dietary fats has also been reported to result in increased levels of postprandial inflammation. However, the effects of dietary fats have been less than carbohydrates and more than dietary proteins. Of individual fatty acids, dietary intakes of MUFA (monounsaturated fatty acid) and high doses of ω3 fatty acids have been associated with reduced postprandial inflammation.Conclusion: Dietary intakes of carbohydrates, followed by dietary fats, are associated with elevated levels of postprandial inflammation. Further investigations are needed to confirm these conclusions.