Recently, neck circumference has been considered a screening index for metabolic syndrome, which is rising in Korea. This study aimed to investigate the relationship between neck circumference, energy nutrient intake, and metabolic syndrome caused by menopause in middle-aged women using data from the 8th KNHANES. Menopausal status showed a significant difference in energy nutrient intake (P<0.05), however no correlation with neck circumference was observed. Regarding the correlation between the metabolic syndrome diagnostic components and neck circumference, only HDL cholesterol showed a negative correlation, whereas all other diagnostic components showed a positive correlation in both groups. Among the diagnostic components for metabolic syndrome, the HDL cholesterol level (P<0.01) was lower in the postmenopausal group; however, the levels of the other components were higher than those in the pre-menopausal group (P<0.05, (P<0.001). The prevalence of metabolic syndrome was significantly higher in the post-menopausal group (34.4%) than in the premenopausal group (19.2%). The neck circumference reference point calculated using ROC curve analysis for the diagnosis of metabolic syndrome was higher in the pre-menopausal group (33.5 cm) than in the post-menopausal group (33.0 cm). The odds ratio for the effect of the neck circumference reference point on the prevalence of metabolic syndrome were 14.571 and 7.287 in the in the premenopausal and post-menopausal groups, respectively. This study showed that neck circumference has potential as a diagnostic index for metabolic syndrome in middle-aged women; however, it is necessary to reflect the standard neck circumference by menopause status