Objective: Microalbuminuria (MAU) is a well-recognized marker of organ damage and sub-clinical CVD in hypertension. Association of MAU with obesity were well documented, but less in normal weight persons. We considered Metabolic risk components and MAU in normal weight hypertension because of a less recognized. Our aim was to examine comparison a prevalence Microalbuminuria (MAU) and Metabolic risk components of Metabolic Syndrome (MetS) in Normal Weight with hypertension. Methods: From a total of 1,461 hypertension attended 11 primary care settings in southern Thailand, 571 were normal weight, and 302 cases were eligible. MetS was stratified by using NCEP-ATP III criteria. Abdominal Obesity (AOB) was defined based on NCEP-APC criteria. We compared MAU and Metabolic risk component of MetS using Chi-square, and odds ratio (OR) with 95% confidential interval (95%CI). Results: Prevalence of MAU was 42.4%. Prevalence of MetS was 58.9%. Prevalence of MetS with MAU was 70.3%. Prevalence metabolic risk component were Low high-density lipoprotein cholesterol (LHDL) 54%, Hight Triglyceride (HTG) 50.7%, High plasma glucose (HPG) 43.7% and AOB 32.1%. Compared metabolic risk component among MAU and non-MAU. Most common metabolic risk component were HPG, AOB and MetS, HPG (54.7% VS 35.6%, OR 2.18, 95%CI 1.37-3.48), AOB (39.8% VS 26.4%, OR 1.84, 95%CI 1.13-3.00), MetS (70.3% VS 50.6%, OR 2.32, 95%CI 1.43-3.75). HTG 52.3% VS 49.4%, LHDL 57.8% VS 51.1%, were not significantiy differences. Conclusion: Our study has shown the high prevalence of metabolic risk component and MAU in normal weight in hypertension. HPG, AOB, MetS induce MAU positive especially Normal weight with hypertension may increment risk of microalbuminuria and cardiovascular disease if they had MetS.