The role of homocysteine (Hcy) and associated oxidative stress processes in the metabolic syndrome (MetS) continuum has not been explored extensively. Changes in Hcy and associated oxidative stress in relation to the number of metabolic syndrome factors present are explored in this study. Method Participants (n = 266) attending a rural diabetes screening clinic had their medical history recorded as well as body mass index, Hcy, glucose, cholesterol, glutathione (GSH), and 8-hydroxy-2-deoxyguanosine (8-OHdG) measured. Result A significant elevation in Hcy (9.5 μmol/L ± 2 vs. 10.6 μmol/L ± 3, p = 0.03) and 8-OHdG (307 pg/mL ± 516 vs. 1130 pg/mL ± 1155, p = 0.0001) was observed between the noMetS and MetS groups. Hcy increased with the addition of MetS factors paralleled by 8-OHdG and GSH. A dramatic increase was seen in 8-OHdG, nearly doubling between 2 MetS and 3 MetS factors present (p = 0.0001). Conclusion Homocysteine may be a useful marker together with 8-OHdG in assessing the extent of metabolic syndrome in a rural population.