Abstract: Objective To assess the prevalence of residents with metabolic syndrome in Qingyang city, Gansu province. Methods A multistage stratified cluster sampling method was conducted. A total of 1511 adults carried on physical examination (range 18-89 years old) from Qingyang city in Gansu were included in the analyses. Metabolic syndrome was diagnosed using the modified National Cholesterol Education Program Adult Treatment PanelⅢ (ATPⅢ) guidelines 2001 and the Guidelines for Prevention and Treatment of Hypertension in China (GCADP) 2007. Results The prevalence of metabolic syndrome diagnosed by using the modified ATPⅢ criterion was 17.14% (20.67% in males and 12.81% in females, respectively). The prevalence of metabolic syndrome was increased with age. The most frequent combination was hypertension with high TG hyperlipidemia and low HDL-c hyperlipidemia. The prevalence of metabolic syndrome diagnosed by using the GCADP criterion was 21.24%, and the most frequent combination was central obesity with high TG hyperlipidemia and low HDL-c hyperlipidemia. The metabolic syndrome was significantly correlated with smoking. Conclusion Metabolic syndrome has become a noteworthy public health problem. The prevention of metabolic syndrome is urgently warranted.