Objective: The aim of this study was to evaluate the association between psychological damage caused by common occupational trauma and metabolic syndrome (MES). Method: 571 workers from 20 small Italian companies were invited to fill in the Psychological Injury Risk Indicator (PIRI) during their routine medical examination at the workplace. Results: Compared to workers with no psychological injury, workers with a high PIRI score had a significantly increased risk of having at least one metabolic syndrome component (adjusted hazards ratio, 1.8; 95% confidence interval, 1.2 to 2.6). There was a significant increase in the risk of hypertriglyceridemia in male workers (OR 2.53 CI95% 1.03-6.22), and of hypertension in female workers (OR 2.45 CI95% 1.29-4.66). Conclusion: Psychological injury related to common occupational trauma may be a modifiable risk factor for metabolic syndrome.