Our purpose was to determine the relationship of metabolic syndrome (MetS) and its components with retinal microvascular abnormalities in a rural Chinese population. The Handan Eye Study, a population-based survey, recruited 6,830 (90.4 % of eligible) rural Chinese a parts per thousand yen30 years of age. A diagnosis of metabolic syndrome was based on the International Diabetes Federation definition. Retinal microvascular signs and arteriolar and venular diameters were assessed from fundus photographs by graders who were trained at the Retinal Vascular Imaging Centre, University of Melbourne. After adjusting for age, gender, and smoking status, 5,519 participants with MetS, or with the specific components of large waist circumference, elevated blood pressure (BP), or elevated fasting blood glucose (FG), were more likely to have retinopathy, arteriovenous nicking, focal arteriolar narrowing, enhanced arteriolar wall reflex, and generalized retinal arteriolar narrowing than those without MetS or the corresponding component. Individuals with elevated triglycerides were significantly more likely to have arteriovenous nicking and retinopathy. These results show that individual components of MetS are associated with different retinal microvascular signs and with changes in retinal arteriolar and venular diameters.