Objective Increased carotid artery intima-media thickness (CIMT) and carotid Plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease (CVD). The components of metabolic syndrome (MetS) are linked to CVD, but the association between Metsand CVD is controversial. Methods A total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities. Metswas defined by the Intational Diabetes Federation criteria. CIMT and carotid Plaque were measured using color Doppler ultrasound. Logistic regression models were used to assess the association of Metswith carotid Plaque and CIMT. Results Metswas found among 3,461 (3,461／8,933) Participants. The odds ratio and 95% confidence intal (CI) for carotid Plaques in Participants with Metswas 1.16 (1.03-1.30). The risk of carotid Plaques increased with the number of Metscomponents. The average CIMT was higher in Participants with Mets(β=0.020, 95%CI, 0.014-0.027) and in Participants with more Metscomponents. conclusion Individuals with Metsare at an increased risk for carotid atherosclerosis compared to those without MetS.