Aim Using multiple tracking techniques (MTT) to analyze and evaluate the changes of atherosclerosis plaque biomechanics patients with metabolic syndrome (MS). Methods 126 patients with metabolic syndrome according to the diagnostic standard of International Diabetes Federation (IDF) and 60 normal subjects were examined using multiple tracking techniques, which dynamic imaging was acquired from all subjects and all above images were stored for off-line analysis with dedicated MTT workstation and all mechanical parameters were collected, including the peak velocity, strain and strain rate of plaque and without plaque, the cap and shoulder of plaque, intima media thickness. The above parameters at different points of carotid intima were compared and studied. Results The level of intimal-media thickness (IMT) in MS patients was higher than that in normal control contract (P<0.05). The systolic maximum velocity and strain of carotid with normal control were significantly higher than that of carotid without plaque with MS (P<0.05). The systolic maximum velocity and strain rate of soft plaque were increased significantly than those of hard plaques. The systolic maximum velocity and strain rate of fabric cowl in the plaque were significantly lower than the shoulder of the plaques (P<0.05). Conclusion The MTT could detect the elasticity of blood vessel wall, sclerosis and the mechanism asynchrony of the carotid artery, and then could be used as the predictive parameter and quantization for atherosclerosis and vulnerable plaque instability.