Objective The association of metabolic syndrome (MetS) with cardiovascular diseases (CVD) has not been adequately explored in middle-aged and elderly Chinese.This study aimed to investigate MetS’ prevalence and its impact on the CVD incidence in this specific population group.Methods A data set of a community-based prospective cohort study was analyzed.A total of 2300 subjects aged 40-94 years were followed up for the CVD events.MetS defined according to the JCDCG criteria was assessed at baseline,and the middle-aged and elderly groups were classified by the WHO definition.Results As compared with the middle-aged group,the prevalence of MetS increased by 0.6 times (34.6% vs.21.3%) and the incidence density of CVD increased by 4.9 times in the elderly group (52.3/1000 person-year vs.8.9/1000 person-year).Furthermore,the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group (HR=2.23,P<0.01) and to elevated blood glucose in the elderly group (HR=1.39,P<0.01).Conclusion MetS was highly prevalent in middle-aged and elderly Chinese.MetS significantly increased the risk to CVD incidence in the elderly.All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD. Objective The association of metabolic syndrome (MetS) with cardiovascular diseases (CVD) has not been adequately exploded in middle-aged and elderly Chinese.This study aimed to investigate MetS ’prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times (34.6% vs. 21.3%) and the incidence density of CVD increased by 4.9 times in the elderly group Fmrthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group (HR = 2.23, P <0.01 ) and to elevated blood glucose in the elderly group (HR = 1.39, P <0.01) .Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to CVD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.