Abstract： Objective： To explore the syndrome rules of metabolic syndrome based on study of traditional Chinese medicine (TCM) syndrome elements. Methods： The medical records of 912 patients with metabolic syndrome were included in the study. Among the medical records， the TCM syndrome types were divided into disease location syndrome elements and disease-nature syndrome elements. The distribution patterns of different disease locations and concurrent diseases of metabolic syndrome，as well as the situation of complications were explored. The characteristics of TCM syndrome elements and their correlation with gender and age were analyzed. Results： Among 912 patients with metabolic syndrome， diabetes，hypertension and obesity are common complications. The frequency ranging from high to low of twelve common TCM syndrome types were： damp- turbidity stasis obstruction， accumulation of qi deficiency and damp- heat， spleen deficiency and dampness stasis， qi deficiency and blood stasis， yin deficiency and blood stasis， spleen and kidney qi deficiency， liver stagnation and spleen deficiency， spleen and kidney yang deficiency，liver and kidney deficiency，water- dampness stasis obstruction，yin deficiency and exuberant heat， and kidney deficiency and blood stasis. Eight common TCM syndrome elements were selected， namely qi deficiency， dampness， spleen， stasis， yang deficiency， yin deficiency， liver， and kidney. According to the frequency ranging from high to low， the disease- nature syndrome elements were qi deficiency，dampness，stasis，yin deficiency，and yang deficiency，and the disease- location syndrome elements were spleen， kidney， and liver. The percentages of syndrome elements including stasis，dampness，liver，and qi deficiency in different genders were compared，and the differences were statistically significant (P＜0.05). Gender had a positive correlation with yin deficiency， qi deficiency， stasis， and liver syndrome elements (P＜0.05)， and it had a negative correlation with dampness syndrome element (P＜0.05). There is no correlation between gender and yang deficiency， spleen，and kidney. There was a significant difference being found in the percentages of spleen syndrome element between elderly patients (aged≥65 years) and non- elderly patients (aged<65 years) (P＜0.05). There was a negative correlation between age group and spleen syndrome element (P＜0.05). Conclusion： Metabolic syndrome is a syndrome characterized by deficiency in the origin and excess in the superficiality， with qi deficiency，yin deficiency，and yang deficiency as the root causes，damp-turbidity and static blood as the symptoms. Men are more prone to appear damp- turbidity syndrome and less liver stagnation syndrome than women，and women are more prone to appear blood stasis syndrome. Gender differences should be emphasized in clinical practice. Non-elderly patients are more likely to develop spleen deficiency syndrome than the elderly patients.