Aim To compare the expression of Toll like receptor 4(TLR4) in blood mononuclear cells and plasma high-sensitivity C-reactive protein (hs-CRP) between metabolic syndrome (MS) patients and simple hypertensive patients. Methods There were 62 EH patients and 45 patients with MS. The TLR4 positive rate in blood mononuclear cells was detected by flow cytometry. We also detected the plasma hs-CRP of the patiens. Single factor analysis was performed on TLR4, hs-CRP and other observation indexes (age, sex, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)), and then multi-factor regression analysis was also performed. Results TLR4 and hs-CRP were statistically significant between MS group (5.7%±1.2% and 5.6±0.9 mg/L) and EH group (5.3%±0.9% and 5.0±0.8 mg/L) (t values were -3.274, -2.225, P values were 0.028, 0.01)； Single factor analysis showed that TLR4 was positively correlated with TC, LDL, HbA1c, FBG,2-hour postprandial blood glucose (2hPBG) and hs-CRP (P＜0.05), and hs-CRP was positively correlated with TC, LDL, HbA1c, FBG,2hPBG, TLR4 (P＜0.05)； Meanwhile, multi-factor regression analysis showed that hs-CRP and HbA1c were the most significant factors which affected TLR4(β values were 0.745,0.244, P values were 0.000,0.004), and TLR4 was the most significant factor which affected hs-CRP (β=0.943, P=0.000). Conclusion It is MS patients that have higher TLR4 positive rate in mononuclear cells and plasma hs-CRP compared with EH patients. TLR4 positive rate and plasma hs-CRP levels of MS patients are positively correlated. And TLR4 may be involved in the development and progression of MS.