Objective: To explore the relationship between C-reactive protein (CRP) and metabolic syndrome (MetS) in a rural Chinese population. Design and methods: We performed a population-based cross-sectional study. Results: The median CRP was 0.90 mg/L. After exclusion of subjects with a CRP value > 10 mg/L, The median CRP with 0, 1, 2, 3, 4, and 5 components of MetS were 0.61, 0.61, 0.73, 1.07, 1.51, and 1.16 mg/L (P=0.029 for linear trend) in men, and were 0.37, 0.45, 0.62, 1.10, 1.52, and 2.17 mg/L (P=0.002 for linear trend) in women, respectively. After adjustment for potential confounders, compared with those without components of MetS, those with 1, 2, 3, 4, and 5 components of MetS had ORs of 1.39, 1.08, 1.84, 2.65, and 1.21 for elevated CRP in men and 1.91, 2.06, 3.10, 4.06, and 6.01 in women, respectively. Conclusion: In this rural Chinese population, the CRP concentration was lower than that of Caucasians and strongly related to the MetS, especially in women. (c) 2009 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.