The purpose of this study was to examine the impact that the revised American College of Cardiology/American Heart Association (ACC/AHA) hypertension diagnostic criteria would have on the prevalence of metabolic syndrome (MBS) among college students. Students completed an objective health assessment between September 2015 and April 2018 that involved the assessment of abdominal girth, blood glucose, lipids, and blood pressure (BP). Data of 5681 students (60.1% Men; 21 ± 1 years) who had all MBS risk factors assessed were analyzed to compare differences between old and new diagnostic criteria and identify which component of BP best predicts metabolic risk factors. The prevalence of MBS increased by 40.6% and 104.5% with the change to ACC/AHA criteria from the AHA/National Heart Lung and Blood Institute and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP criteria, respectively. The greatest relative increase in the prevalence of MBS was observed among women. Systolic BP and diastolic BP were significant predictors of abdominal obesity, and diastolic BP was a significant predictor of elevated triglycerides. Changes in hypertension diagnostic criteria had a significant impact on MBS prevalence. This is positive as it will allow earlier identification of young adults at risk of developing various noncommunicable diseases, but the ability of colleges to identify and then intervene to improve the health of at-risk students remains unclear. Furthermore, findings indicate that BP may hold utility as a cost-effective predictor of certain metabolic risk factors in the absence of efficient, accurate, and affordable alternatives.