Abstract: Metabolic syndrome (MetS) is the pathological state of abnormal accumulation of various metabolites that always manifest a series of syndromes characterized by cardiovascular risk factors including central obesity, hyperglycemia, dyslipidemia and hypertension, which are highly correlated with the growing morbidity and mortality rates for cardiovascular diseases (CVD). The correlation between these metabolic disorders and the development of CVD is identified to be complex and multifactorial in which insulin resistance (IR), oxidative stress, low-grade inflammation and vascular maladaptation are considered to be the leading causes. Hence, multifaceted comprehensive treatment scheme should be used to treat patients with MetS. Lifestyle changes such as weight control, healthy heart diet and regular exercises have been recommended as the first line measures to reduce the risks of CVD in MetS individuals. Improving insulin resistance and glucose metabolism, controlling blood pressure and adjusting dyslipidemia can also reverse or slow down the process of CVD in MetS. This review aims to elaborate the complex relationship between MetS and CVD, to discuss the optimal treatment regimens to prevent and treat cardiovascular complications in MetS patients and to introduce the updated results from newly released clinical trials.