Aim To explore the relationship between different components of metabolic syndrome and carotid intima-media thickness. Methods 79 elder metabolic syndrome patients(more than 60 years old) were divided into two groups according to the different components of metabolic syndrome;41 patients with diabetes mellitus and 38 patient without diabetes mellitus.Meanwhile,37 patients with diabetes mellitus is younger than 60 years old.Carotid intima-media thickness was measured by Doppler ultrasonography. Results Carotid artery intima-media thickness in elderly patients are significantly thicker than that of younger ones(p<0.001),while intimamedia thickness combining with diabetes mellitus are significantly thicker than that without diabetes mellitus in elderly patients(p<0.05).By correlation analysis,the carotid artery intima-media thickness was positively correlated with age(r=0.300,p<0.001),duration of hypertension(r=0.255,p<0.001).The occurrences of plaque are highest in elderly patients with diabetes mellitus(73.2%),secondly in elderly patients without diabetes mellitus(50%) and lowest in younger patients with diabetes mellitus(21.6%),Statistical analysis is positive(p<0.05 and 0.001). Conclusion Intima-media thickness combining with diabetes mellitus are significantly thicker than that no diabetes mellitus in metabolic syndrome in elderly patients.Elder metabolic syndrome patients have higher carotid intima-media thickness than younger ones.