Aim To explore the relationship between multiple cardiovascular and metabolic diseases and falls in middle-aged and elderly people.Methods Using the fifth dataset of the China Health and Retirement Longitudinal Study(CHARLS),18 968 middle-aged and elderly people aged 45 years and above were enrolled as study subjects.The relationship between multiple cardiovascular and metabolic diseases and falls was analyzed by Logistic regression model.Results The incidence rates of falls,severe falls and hip fractures in the study subjects were 17.3％,6.8％and 0.9％,respectively.Cardiovascular and metabolic diseases were positively associated with the risk of falls.Compared with study subjects without cardiovascular and metabolic diseases,those with 1,2,3 and 4 cardiovascular and metabolic disea-ses had a 13％,44％,69％and91％increased risk of falls,respectively,with OR(95％CI)of 1.13(1.02～1.25),1.44(1.29～1.61),1.69(1.48～1.93)and 1.91(1.56～2.32);the risk of serious falls increased by 22％,51％,69％and 102％,respectively,with OR(95％CI)of 1.22(1.05～1.42),1.51(1.27～1.78),1.69(1.38～2.05)and 2.02(1.54～2.66).The risk of hip fractures increased by 95％,147％and 157％in study subjects with2,3 and 4 cardiovascular and metabolic diseases,respectively,with OR(95％CI)of 1.95(1.24～3.05),2.47(1.50～4.07)and 2.57(1.26～5.20).Conclusion Multiple cardiovascular and metabolic diseases significantly increased the risk of falls in middle-aged and elderly people.