Purpose: The prevalence of metabolic syndrome in the pediatric population is increasing. Barriers, including the lack of consensus of a definition for metabolic syndrome and time constraints for the pediatrician, may limit the identification and diagnosis of metabolic syndrome in children. The objective of this pilot study was to evaluate the role of a clinical pharmacist (CP) in screening children and adolescents for metabolic syndrome. Methods: A 3-month, prospective, cross-sectional study aimed at utilizing a CP to identify metabolic syndrome in high-risk children, ages 10-18 years, in a pediatric ambulatory clinic located in a rural community health center was conducted. Upon enrollment a personal and family medical history was obtained, physical examination was reviewed, and a fasting laboratory analysis was performed. The CP evaluated each component of metabolic syndrome to determine if the participant met criteria for diagnosis. The CP provided a summary of the risk factors and treatment recommendations to the pediatrician. Findings: Twenty-five Mexican American participants (ages 13.7 [plus or minus] 2.3 years) enrolled and completed the study. One child (4%) met 3 or more criteria required for diagnosis of metabolic syndrome. Of the remaining participants, 7 (28%) met 2 criteria, 9 (36%) met 1 criterion, and 8 (32%) met no criteria for metabolic syndrome. The CP provided treatment recommendations for 68% of the participants. Conclusion: CPs can have an active role in early identification of specific components of metabolic syndrome in a rural community health center.