Metabolic syndrome (MetS) is a cluster of metabolic abnormalities sharing potential common underlying mechanisms. Insulin-degrading enzyme (IDE) plays a primary role in insulin degradation and cellular insulin processing and therefore affects glucose and lipid metabolism. Genetic association studies have been focused on the relationship between the IDE gene and the development of MetS. To identify specific genetic risks for MetS associated with IDE gene, a case-control association study was performed on 563 Chinese elders in Shanghai, China. Cases were those with MetS (n = 241), and controls were those without MetS (n = 219). Five unrelated genetic markers (single nucleotide polymorphisms) at the IDE gene were used for association analyses. The single-locus association analysis revealed that the A/T allele of rs11187033 was associated with MetS (odds ratio = 0.698; 95% confidence interval, 0.526-0.928; P = .013). Patients with MetS had more haplotype G-T-Ts than controls (P = .008). None of the other 4 single nucleotide polymorphisms was significantly associated with MetS. This result suggests that the rs11187033 at IDE gene might contribute to MetS susceptibility in Chinese elders.