Objective The aim was to study the impact of metabolic syndrome on the risk for disability pension among Swedish employees. Methods A working population-based prospective cohort [Work, Lipids and Fibrinogen (WOLF) cohort, 14=10 803], was linked to national registry records of all-cause disability pension for the period 1992-2013. Occupational health service data included 1992-2009 anthropometric measurements, blood samples, and questionnaires. Metabolic syndrome was defined according to International Diabetes Federation criteria, and risk for any all-cause disability pension was analyzed using Cox proportional hazard regression as hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, sex and other covariates. Results Of the employees, 17.9% (men 21.5%, women 9.7%) met the criteria for metabolic syndrome. The prevalence of all-cause disability pension was 15.2% in men with metabolic syndrome and 7.5% in men without metabolic syndrome; for women, the corresponding results were 23.2% and 12.7%. After adjustment for sociodemographic factors, health behaviors, work-related factors, diabetes, and obesity, the risk for all-cause disability pension among subjects with metabolic syndrome displayed an HR of 1.37 (95% CI 1.18-1.60). Results were similar for men and women. In a subgroup, further adjustment for chronic diseases resulted in an HR of 1.32 (95% CI 1.04-1.68). Conclusion This study demonstrates an increased risk for all-cause disability pension, even after adjustment for other risk factors, among Swedish employees with metabolic syndrome compared to those without at baseline.