Objective The aim of this study was to analyze the relationship between handgrip strength (HGS) and metabolic syndrome (MetS) in people living with HIV (PLHIV). Methods Cross-sectional study, with 207 PLHIV from an outpatient clinic in the municipality of Santar & eacute;m, Par & aacute;, Brazil. Sociodemographic, clinical, laboratory, physical activity, sedentary behavior, HGS, and MetS information was collected. Data were analyzed using descriptive and inferential statistics, adopting p < 0.05. Results It was observed that 15.4% of the included PLHIV have MetS and 28.5% present low HGS. In addition, a positive relationship was found between low HGS and smoking (p = 0.011), high abdominal circumference (p = 0.001), overweight/obesity (p < 0.001), and high systolic (p = 0.040) and diastolic (p = 0.037) blood pressure values. On the other hand, metabolic syndrome was positively associated with the female sex (p = 0.045), age >= 40 years (p < 0.001), duration of antiretroviral therapy use > 36 months (p = 0.008), abdominal obesity (p < 0.001), overweight/obesity (p < 0.001), low HDL-c (p < 0.001), hyperglycemia (p < 0.001), hypertriglyceridemia (p < 0.001), and elevated systolic and diastolic blood pressure (p < 0.001). Conclusion Based on the presented results, it is concluded that low HGS was not directly associated with MetS. However, low HGS demonstrated an association with altered values of abdominal circumference, body mass index, and blood pressure, all of which are risk factors for MetS.