Abstract： AIM: To investigate the clinical features of colorectal neoplasm patients with metabolic syndrome (MS).METHODS: A retrospective analysis was performed of clinical data for patients who were diagnosed with colorectal neoplasm with MS from May 2012 to May 2015.RESULTS: A total of 107 patients were included.There were 72 males and 35 females, and their mean age was 66.84 years ± 10.58 years.There were 40 cases of adenomas and 67 cases of colorectal cancer.There was no significant difference (P ＞ 0.05) in the rate of reduced high density lipoprotein-cholesterol (HDL-C) [29 (72.5％) vs 53(79.1％)] between patients with adenomas and those with colorectal cancer, but the rate of elevated triacylglycerol [14 (35.0％) vs 45 (67.2％)] differed significantly (P ＜ 0.05).The rates of elevated CEA and CA199 showed no significant difference between patients with adenomas and colorectal cancer (P ＞ 0.05);however, the rate of elevated CA125 and the rate of elevation of two or more of the three tumor markers were significantly higher in the colorectal cancer group than in the adenoma group (P ＜ 0.05).In colorectal neoplasm patients with MS, 20 developed carcinoma metastases, and 16 cases died;the median survival time was 33 mo.CONCLUSION: Colorectal neoplasm patients with metabolic syndrome are always diagnosed at old ages, and high level of TG may play a role in the evolution of colorectal adenomas to colorectal cancer.Joint detection of multiple tumor markers can be used to distinguish benign and malignant lesions in these patients.