Objective To analyze the clinical characteristics and risk factors of cerebral infarction complicated with metabolic syndrome in the elderly patients. Methods A total of 154 elderly patients diagnosed with cerebral infarction were collected from Friendship Hospital in Yangzhou, 80 being complicated with metabolic syndrome (observation group) and 74 elderly being not (control group). The two groups were then compared in the general clinical data, plasma cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) fasting blood glucose(FBG), systolic blood pressure, diastolic blood pressure, postprandial blood glucose, fasting insulin, neurological function and complications. Multivariate logistic regression analysis was performed on the related factors of cerebral infarction complicated with metabolic syndrome. SPSS statistics 21.0 was used for statistical analysis. Data comparison between two groups was perfomed using χ²test or t test depending on date type. Results In observation group, BMI was (28.3±3.5) kg/m², waistline (94.6±10.2) cm, smoking history 35(43.8%), drinking history 33(41.3%), hypertension 57(71.3%), hyperglycemia 68(80.0%) and hyperglycemia blood lipids 49(61.3%), which were all higher than those in control group [25.7±2.9) kg/m², (89.3±9.4) cm, 20(27.0%)、18(24.3%)、36(48.6%)、39(52.7%)、30(40.5%)], with statistically significant difference (all P<0.05). In observation group, TC was (5.25±1.13) mmol/L, TG (2.36±0.85) mmol/L, FPG (7.83±0.87) mmol/L, systolic blood pressure (149.32±12.41) mmHg (1mmHg=0.133kPa), diastolic blood pressure (89.34±9.12) mmHg, 2 h postprandial blood glucose (10.81±3.45) mmol/L and fasting insulin (10.86±2.75) mmol/L, which were all higher than those in control group [(4.89±0.94) mmol/L, (1.82±0.64) mmol/L, ( 6.28±0.57)mmol/L, (141.71±11.52)mmHg, (82.31±7.61)mmHg, (7.87±3.14)mmol/L and (8.49±2.53)mmol/L], while HDL-C in observation group [(0.94±0.24) mmol/L] was lower than that in control group [(1.08±0.36) mmol/L], with statistically significant differences (all P<0.05). In the observation group, the rate of neurological function score as (24.62±6.74) points, the rate of neurological function score as severe 41.3%(33/80), lung infection 11.3%(9/80), heart failure 28.8%(23/80), and liver and kidney failure 16.3%(13/80), which were all higher than those of the control group [(17.21±6.25) points, 21.6%(16/74), 2.7%(2/74), 9.5%(7/74), 4.1%(3/74)], with statistically significant differences (all P<0.05). There was no statistically significant difference in the recurrence rate of cerebral infarction between two groups (P>0.05). Logistic regression analysis showed that hypertension, FPG≥6.1 mmol/L, TG≥1.7 mmol/L, obesity and pulmonary infection were the risk factors of cerebral infarction complicated with metabolic syndrome in the elderly patients. Conclusion The elderly patients with cerebral infarction complicated with metabolic syndrome have serious illness and poor prognosis. Hypertension, FPG≥6.1 mmol/L, TG≥1.7 mmol/L, obesity and pulmonary infection are the risk factors.