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Purpose: The purpose of this study was to examine the effectiveness of Participatory Action-Oriented Training (PAOT) programs in korean manufacture workers with metabolic syndrome for three years. Methods: A total of 890 workers with risks of metabolic syndrome were recruited from one workplace. The experimental group (n=51) received PAOT program for the preventive management on metabolic syndrome, while the control group (n=51) received conventional program. Results: In the experimental group who participated in PAOT program, percentage of achieved action plans was 73.4% at three months, 75.8% at six months, 82.8% at three years. After three years, the rate of risk factor in the experimental group has significantly decreased from 1.94±1.77 to 0.76±1.25 for moderate exercise, and from 1.72±2.01 to 1.04±1.59 for the strenuous exercise. Systolic and diastolic blood pressure has significantly decreased from 125.06±11.83 to 117.65±19.94, from 83.45±13.38 to 76.39±8.09 mmHg. In addition, risk factor score also decreased from 3.31±0.61 to 1.41±0.89. Conclusion: To improve the effectiveness of PAOT program for the management of risk factors of metabolic syndrome, there is a need to continue implement programs and analyze the long-term effects are required in the workplace.