Objectives: People who are homeless have high mortality and morbidity, including from metabolic disorder. The aim of this study was to report on the characteristics and progress of the metabolic health of people attending a metabolic clinic at a homeless men’s shelter. Methods: Homeless men attending the clinic were assessed by measuring their weight, height, body mass index (BMI), waist circumference, blood pressure, blood lipids, fasting blood glucose and, if indicated, HbA1c. The sample characteristics of people who attended once (one-off clients) were compared to those who attended on more than one occasion (returning clients). Changes in health status were examined among returning clients by comparing baseline results to those at their last clinic visit. Results: Baseline data were recorded on a total of 136 men, of whom 126 had a consultation with a general practitioner and at least one blood test. The 136 clients had a median BMI of 27.4 kg/m². Forty-three were obese (BMI ≥30 kg/m²), 18 had class II obesity (BMI >35 kg/m²) and seven were underweight (BMI <20 kg/m²). Sixty-five had an intervention for either a newly diagnosed condition or a change to existing medical treatment. Seventy-six returning clients were seen on an average of 2.3 further occasions. Returning clients had significant improvements in measures of metabolic health. Conclusions: Homeless people in Sydney appear to be at a high risk of metabolic disease. The feasibility of a metabolic health clinic was demonstrated, and an encouraging improvement in some health indicators was found.