Limited information is available on the relationship between metabolic syndrome and stroke in the Chinese population. The aim of this study was to establish the prevalence of metabolic syndrome in the Chinese population and the relationship between stroke and metabolic syndrome in that population. 2,173 subjects aged 45 years and above without a history of stroke were recruited from six communities in Chongqing city, China. The participants were followed for incident stroke events (ischemic stroke and hemorrhagic stroke) for 5 years. Incidence rates and hazard ratios (HRs) for both subtypes of stroke were stratified by the presence or absence of metabolic syndrome and by each component. Among the subjects, women had a higher prevalence rate of metabolic syndrome than men (26 vs. 19%). As the number of metabolic syndrome components increased, HRs increased significantly, up to 5.1 (95% CI, 1.9-7.4) for ischemic stroke and 3.3 (95% CI, 1.7-5.7) for hemorrhagic stroke. We found that abdominal obesity had the highest HR (2.12, P < 0.001) for ischemic stroke, followed by metabolic syndrome (HR 1.65, P < 0.001). For hemorrhagic stroke, high blood pressure had the highest HR (2.17, P < 0.001), followed by abdominal obesity (HR 1.83, P < 0.001). After 5-year follow-up, the survival rates of stroke events were 94.2% among those with metabolic syndrome and 96.9% among those without. As the number of metabolic syndrome components increased, survival rates decreased progressively, from 99.6% for individuals with none of the components to 90.1% for those with four to five components. The results showed that metabolic syndrome is highly prevalent among the Chinese adult population and is associated with an increased risk for both ischemic stroke and hemorrhagic stroke.