To investigate relationship between overactive bladder (OAB) and metabolic syndrome (MtS) by using neck circumference (NC). In retrospective view of prospective collected data, 204 women with or without OAB were enrolled into study, between August 2012 and December 2013. All patients were administered OAB validated questionnaires (OAB-V8) and whose score was >8 were accepted as OAB. Patients were divided into two groups and group 1 consisted of patients with OAB, group 2 consisted of patients without OAB. Demographic data with anthropometric measurements and blood analyses were recorded. Statistical analyses including receiver operating characteristic (ROC) curves were performed; statistically significant p was < 0.05. Mean age was 41.06 +/- 9.78 years. There were 115 (56.4 %) patients in group 1, and 89 (43.6 %) patients in group 2. OAB-V8 scores were significant higher in group 1 than group 2 (p < 0.001). Waist circumference (WC) and NC measurements were statistical significant longer in group 1 than group 2 (p < 0.001). In multivariate logistic regression analyses age, body mass index, MtS, WC, and NC were statistical significant associated with OAB. In ROC curves, area under the curve (AUC) was 0.72 cm(2) for relationship between OAB and WC (p < 0.001), and AUC was 0.73 cm(2) for relationship between OAB and NC (p = 0.004). Cut-off NC and WC values for OAB were determined as 35.25 cm and 98.5 cm, respectively. OAB with metabolic syndrome seems like more common in women than in those without. NC may be a novel indicator for OAB in selected female patients with MtS.