Aim To investigate the relationship between adiponectin,metabolic abnormalities and cerebral artery atherosclerotic stenosis in patients with acute cerebral infarction complicated by metabolic syndrome(MS). Methods 74 patients with acute ischemic stroke were studied who were hospitalized.All subjects were divided into MS group and non-MS group with the criteria of MS published by international diabetes federation(IDF).All patients underwent magnetic resonance angiography(MRA) to measure the intra-and extra-cranial atherosclerotic stenosis and reveal the incidences of stenosis.The values of plasma adiponectin were detected for all patients too. Results The frequency of cerebral arterial stenosis in patients with acute cerebral infarction in MS group and non-MS group were 85.0% and 64.7%,respectively,and there was statistical significance between the two groups(p=0.039).The patients with acute cerebral infarction complicated by MS showed lower levels of plasma adiponectin and higher values of serum triglyceride and the levels of serum total cholesterol(p<0.05),low-density lipoprotein cholesterol and high-density lipoprotein cholesterol had no significant difference compared with the non-MS group(p>0.05).The result of Logistic regression analysis indicated that MS was associated with atherosclerotic stenosis(Or=3.09,p<0.05)and the presense of plasma adiponectin was not the risk factor for cerebrovascular stenosis(Or=1.272,p>0.05). Conclusion The decrease of the levels of plasma adiponectin induced MS and was the cause of metabolic abnormalities.MS was associated with atherosclerotic stenosis.The values of plasma adiponectin was not significantly associated with atherosclerotic stenosis.