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A 14-day Facebook ad campaign targeting a 20-mile radius around Henrietta, NY in English recruited participants with metabolic syndrome (MetS) for the Enhanced Lifestyles for Metabolic Syndrome (ELM) clinical trial. The campaign utilized 11 key phrases and achieved 33,243 unique reaches across 59,449 impressions, generating 1,160 unique ad clicks. Demographic analysis revealed 84% female respondents. The ad successfully identified 21 participants eligible for ELM baseline screening from 1,160 unique clicks. Cost-effectiveness metrics showed a total campaign cost of $708.57, with cost per phone screen eligible participant at $6.22 and cost per eligible ELM baseline screener at $33.74. Facebook's temporal and geographic targeting, along with campaign optimization, enabled efficient recruitment of participants meeting stringent ELM inclusion/exclusion criteria within a short timeframe. The study, supported by the William G. McGowan Charitable Fund and others, demonstrated Facebook as a cost-effective strategy for recruiting eligible MetS participants to a randomized clinical trial testing lifestyle interventions for metabolic syndrome reversal.