Abstract： Objective To investigate the clinical characteristics and the prognosis of acute stroke with metabolic syndrome.Methods 135 acute stroke patients with metabolic syndrome were recruited,and 195 acute stroke patients without metabolic syndrome were selected as controls.Results The prevalence of cerebral infarction was significantly increased in stroke patients in MS group than those in control group.The prognosis of patients in control group(mortality 24.4% ) were better than the stroke patients in MS group( mortality 9.7% ).There was significant difference in severe complication,including pulmonary infection,respiratory failure,heart failure,arrythmias and kidney failure between MS group and control group.However,there was no significant difference in onset of cerebral hernia and gastrointestinal hemorrhage between the two groups.Conclusions The prevalence of cerebral infarction remarkably increased in.stroke patients with metabolic syndrome.The mortality and incidence of complication in stroke with metabolic syndrome is higher.