Objective To investigate the association between metabolic syndrome (MS) and cardio-cerebral vascular diseases in the elderly Beijing residents and its sex-and age-dependent variances. Methods A cohort of 1827 elderly Beijing residents were selected. The physical examination,including height,body weight,blood pressure,several serum metabolic indices,was performed. Metabolic syndrome was diagnosed with China criteria. Demographic data and prevalence of cardio-cerebral vascular diseases in the subjects were investigated. Results The mean age of the subjects was (71±7) years. Among 1827 subjects,there were 372 MS cases,accounting for 20.4%,with higher proportion of women than men. The prevalence of MS remarkably decreased with aging. The prevalence of hypertension was 63.2%,impaired fasting glycaemia 23.5%,overweight and obesity 34.2%,hypertriglyceride 29.8%,and low HDL-C 3.7% respectively,and all were higher in women than in men. Prevalence of diabetes mellitus was 13.7%,and there was no sex-related difference for it. Systolic blood pressure and HDL-C levels increased with aging; while diastolic blood pressure,body mass index,fasting glycaemia and triglyceride levels decreased with aging. The prevalence of coronary heart disease and stroke were higher in the elderly with MS than in those without MS. But,the difference was only seen in the elderly <80 years rather than≥80 years. The prevalence of coronary heart disease in elderly men with MS and prevalence of stroke in elderly women with MS were higher than that in the elderly without MS. Conclusion The prevalence of MS is high in the elderly. Those with MS have a high prevalence of cardio-cerebral vascular diseases,and there exists the sex-and age-related difference.