Objective To explore the regional characteristics of traditional Chinese medicine（TCM） pathological changes in patients with metabolic syndrome（MS） in Jinjiang Fujian. Methods A total of 73 MS patients were collected in Jinjiang Hospital of TCM. Collected four diagnostic information and adopted method of syndrome differentiation to extract syndrome elements and observe pathological changes of MS patients in Jinjiang. Patients were grouped by BMI and gender to analyze the difference of TCM pathology by Statistical methods. Results The main TCM pathological changes of MS patients in Jinjiang area were liver， kidney， spleen， heat， yin deficiency， phlegm， dampness， etc. MS patients in different BMI groups showed significant difference in heat and in different sex groups showed significant difference of liver， both have statistical significance（P＜0.05）. Conclusion The higher the BMI of MS patients in Jinjiang， the more obvious pathological changes of heat and yin deficiency. The pathological changes of the liver were significantly higher in female than in male， which may be related to the climatic， people’s eating habits and MS susceptibility factors in Jinjiang.