The present study aimed to assess the prevalence of the hypertriglyceridemic waist phenotype and its associated factors among subjects that have been followed up from birth. In 1982, all maternity hospitals in the city of Pelotas, in the Southern Region of Brazil, were visited and all births were recorded. Babies whose parents lived in the urban area of Pelotas were subsequently followed up on several occasions. A 22 to 23-year follow-up of this birth cohort was carried out in 2004 and 2005. The presence of the hypertriglyceridemic waist phenotype was defined as waist circumference ≥ 90cm and triglyceride levels ≥ 177mg/dL for males, and waist circumference ≥ 85cm and triglyceride levels ≥ 133mg/dL for females. The prevalence of the hypertriglyceridemic waist phenotype was 5.9% and 4.5% among men and women, respectively. Among males, a sedentary lifestyle during leisure time, smoking and obesity were associated with the presence of the hypertriglyceridemic waist phenotype, whereas among females the condition was positively associated with skin color, family income, obesity and dietary fat intake.