ObjectiveThis study was aimed at investigating the relationship between neuron-specific enolase (NSE) and components of metabolic syndrome (MS).DesignCross-sectional study.SettingChinese health check-up population.Participants40 684 health check-up people were enrolled in this study from year 2014 to 2016.Main outcome measuresOR and coefficient for MS.ResultsThe percentage of abnormal NSE and MS was 26.85% and 8.85%, respectively. There were significant differences in sex, body mass index, drinking habit, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), blood pressure and MS between low-NSE and high-NSE groups. In logistic regression analysis, elevated NSE was present in MS, higher body mass index, hypertriglyceridaemia, hypertension and low-HDL groups. Stepwise linear analysis showed a negative correlation between NSE and fasting blood glucose (FBG) (<6.0 mmol/L), and a positive correlation between NSE and TGs (<20 mmol/L), systolic blood pressure (75–200 mm Hg), HDL-C (0.75–2.50 mmol/L), diastolic blood pressure (<70 mm Hg) and FBG (6.00–20.00 mmol/L). Furthermore, MS was positively correlated with NSE within the range of 2.00–7.50 ng/mL, but had a negative correlation with NSE within the range of 7.50–23.00 ng/mL.ConclusionThere are associations between NSE with MS and its components. The result suggests that NSE may be a potential predictor of MS. Further research could be conducted in discussing the potential mechanism involved.