Objective To study the relationship between serum uric acid (UA) level and metabolic syndrome (MS) in elderly essential hypertensive (EH) patients.Methods Two hundred and one elderly EH patients were divided into hyperuricemia group (n=47) and normal UA group (n=154).Hyperuricemia was defined in males with their serum UA level ＞ 420 μmol/L and in females with their serum UA level ＞ 360 μmol/L.Relationship between serum UA level and MS in elderly EH patients was analyzed by Pearson correlation analysis and logistic regression analysis respectively.Results The age was significantly older,the waist circumference was significantly longer,the BMI and serum SCr,FPG,TG level and the incidence of MS,central obesity,high blood glucose and high TG were significantly higher while the serum HDL-C level was significantly lower in hyperuricemia group than in normal UA group.Pearson correlation analysis showed that waist circumference,BMI,serum FPG and TG level were positively related with serum UA level while serum HDL-C level was negatively related with serum UA level (P＜0.05,P＜0.01).Logistic regression analysis showed that waist circumference and serum TG level were the independent risk factors for elevated serum UA level in elderly EH patients (OR=1.080,95％ CI:1.035-1.127,P=0.000;OR=1.472,95％CI:1.021-2.122,P=0.038).Conclusion Serum UA level is closely related with MS and its components while waist circumference and serum TG level are the independent risk factors for hyperuricemia in elderly EH patients.