Introduction. Elevated aminotransferase levels(ATLs) are alert the physicians for liver-affecting disease and may reflect liver injury. We aimed to determine the prevalence of elevated ATLs and the association of elevated ATLs with the metabolic syndrome(MetS) in a northern province of Turkey. Materials and methods. Elevated ATLs were evaluated among 1,095 individuals of the Tokat Prevalence Study which have been described in detail elsewhere. 1,095 participants had been selected by a simple random sampling method among 530,000 inhabitants in 70 (12 urban and 58 rural) areas in the province of Tokat which is located in the Black Sea Region of Turkey. Results. The prevalence of elevated serum ALT, AST, and ALT and/or AST were found as 11%, 7.2%, and 13.3%, respectively. Increased BMI, fatty liver, and MetS were higher in our general population with elevated ATLs. After exclusion of individuals with hepatitis B or hepatitis C infection, 132 individuals with elevated ATLs (91 male and 41 female) were evaluated. MetS was found in 59 participants and its prevalence was markedly higher in females with elevated ATLs (p < 0.0001). When the males with elevated ATLs were evaluated, the ALT levels of the persons who have no risk of MetS (p = 0.007) and the persons who have one risk of MetS (p = 0.001) were lower than the persons with MetS. Conclusions. Elevated ATLs are common and it's an important cause is MetS in Northern Turkey.