Aim To assess the prevalence of metabolic syndrome and correlative risk factors among the middle-aged and elderly populations in Chengyu area. Methods In 2013, a total of 7807 middle-aged and elder adults aged 40-79 years were enrolled from Chengyu area using a stratified cluster sampling method, to check height, weight, blood pressure, blood fat and oral glucose tolerance test (OGTT), etc. Data were collected through questionnaire and the diagnostic criteria for using the Chinese Medical Association standard complications. Results The prevalence of metabolic syndrome was 13.8%. Male and female prevalence was 13.3% and 14.1%, the prevalence of the sexes had no statistical difference. The urban and rural prevalence was 14.6% and 10.6%, the urban prevalence rate was higher than the rural. There was an increasing prevalence with the increase of age, but it fell slightly above 70-years-old. Age, abdominal obesity, lack of physical exercise were major related factors of metabolic syndrome among middle-aged and elderly male in Chengyu area; Age, family history of hypertension, abdominal obesity were related factors of metabolic syndrome among middle-aged and elderly female. Conclusion There was a high prevalence of metabolic syndrome among the middle-aged and elder adults in Chengyu area. It was important to control reasonable waist circumference for metabolic syndrome prevention and intervention of the crowd and prevent the occurrence and development of cardiovascular disease.