Aim To investigate the effect of the therapeutic lifestyle change (TLC) combined with SWOT analysis and medical social work in patients with metabolic syndrome. Methods Three hundred patients with metabolic syndrome in Shangma community in Qingdao, were randomly divided into two groups (150 cases in each group). The patients in one group(TLC group) had received therapeutic lifestyle intervention for 1 year. And the patients in the other group (improved TLC group) had received the improved therapeutic lifestyle intervention combined with SWOT analysis and medical social work for 1 year. The changes of weight, body mass index (BMI), waistline, blood pressure (BP), fasting blood glucose (FBG) and blood lipid (including triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC)) were evaluated before/after intervention for both groups. Then we calculated the cumulative percentages of patients remaining discharged by Kaplan-Meier method and compared the differences of the rehospitalization by the Log-rank test. Results After the interventions, the weight, BMI, waistline, FBG and blood lipid except BP were significantly improved in improved TLC group (P＜0.05), and the weight, BMI, waistline, TG and HDLC except BP, FBG, TC and LDLC were significantly improved in TLC group (P＜0.05). The weight, BMI, waistline, FBG and blood lipid were improved more significantly in improved TLC group than in TLC group. The results of comparison about the cumulative percentages of patients remaining discharged in the two groups was that the differences was not significant in 10 weeks and was significant in remaining weeks in the two groups(P＜0.05).Conclusion The therapeutic lifestyle change combined with SWOT analysis and medical social work can provide an individuation intervention for the patients with metabolic syndrome,and can resolve the problem of psychosocial and treatment compliance that TLC can’t resolve. The improved TLC can improve the each index of the metabolic syndrome significantly and delay the development of the related complications that is worth to be promoted.