Objective Waist-to-height ratio (WHtR), a measurement of the distribution of body fat, correlated with abdominal obesity indicating that it might be a better predictor of cardiovascular risk and metabolic disease.We, therefore, evaluated optimal WHtR cutoff points according to the risk of framingham risk score ( FRS ) and metabolic syndrome ( MS ) in Chinese .Methods The subjects were from China National Diabetes and Metabolic Disorders Survey during 2007 -2008.Receiver operating characteristic analysis was used to examine the optimal cutoff values of WHtR according to the risk of FRS and MS . Results A total of 27820 women and 18419 men were included in the evaluation .The average age was (45.0 ±13.7 ) years.The proportions of FRS ≥10% and MS increased with WHtR both in men and women.The cutoff points of WHtR for the risk of FRS ≥10%and MS were 0.51, 0.52 in men, and 0.52, 0.53 in women, respectively.When FRS ≥10% and MS were taken into consideration with a certain weights, the pooled cutoffs of WHtR were 0.51 in men, and 0.53 in women, respectively.By using the similar method, the optimized cutoff points were 0.52, 0.51, 0.50 for men and 0.51, 0.53, 0.54 for women in age group 20-39, 40-59 and ≥60 years, respectively.Conclusions The optimal cutoffs of WHtR are 0.51 in men, and 0.53 in women for FRS≥10% in combination with MS indicating that this WHtR cutoff points might be used as indexes to evaluate obesity and risk of obesity -related diseases .