Objective To investigate the association of leptin receptor gene Gln223Arg polymorphism with metabolism syndrome and insulin resistance. Methods The genotypes of leptin receptor in 167 patients with metabolic syndrome and 216 healthy subjects were determined by polymerase chain reaction restriction fragment length polymorphism. The biochemical indicators were detected. Results The frequency of A alleles was significantly higher in patients with metabolic syndrome than in healthy subjects. The risk of metabolic syndrome in inviduals with allele A was 3. 302 folds of that with allele G( P<0.01 ). Compared with allele G, the patients withA allele had higher body mass index,blood pressure, blood glucose, insulin level, waist circumference, and more serious dyslipidemia. The risk of insulin resistance in patients with A allele was 3. 446 folds of that with allele G (P<0.01). Conclusions Leptin receptor gene Gln223Arg polymorphism is associated with an increased risk of metabolic syndrome and insulin resistance.