Objective To investigate the association of metabolic syndrome and calculous chole-cystitis.Methods The retrospective cross-sectional study was conducted between July 2012 to February 2013.Seventy-two consecutive patients with calculous cholecystitis were included as study participants and 58 patients with asymptomatic gallstone were recruited as controls.Basic demographic data,waistline,blood sugar,blood fat,blood pressure,abdominal ultrasonography and other laboratory tests were collected.Re-sults The prevalence of metabolic syndrome in patients with symptomatic gallstone was significant higher than the controls(47.2% vs 22.4%,P<0.05).The presence of the metabolic syndrome(OR 1.452, 95%CI 1.210~1.694,P=0.018)and large gallstones(diameter≥2.5 cm,OR 1.138,95%CI 1.028 ~1.248)were significantly correlated with symptomatic gallstone.Conclusion The presence of metabolic syndrome may increase asymptomatic gallstone patients'risk of developing symptomatic calculous cholecys-titis.