The authors evaluated whether stroke was associated with the metabolic syndrome (MetS) and C-reactive protein (CRP) levels in an ethnic Chinese population, and whether these 2 factors add to traditional risk factors in predicting stroke risk. This study identified 65 subjects who had a stroke for the first time and 109 subjects in the control group free of stroke from a community cohort in a 10-year follow-up period until 2005. Metabolic syndrome, CRP levels, and traditional risk factors were measured in 1994-1995. The multivariate logistic regression adjusted stroke odds ratio was 2.55 (95% confidence interval, 1.05-6.23) for subjects in the top tertile CRP levels compared with the bottom tertile levels in the controls. The risk was not attenuated after further adjustment for MetS. The risk for stroke associated with MetS was eliminated after including hypertension and diabetes in the model. The area under receiver operating characteristic curves for traditional risk factors (0.676) improved little by adding CRP (0.691), MetS (0.688), or the combination of these 2 variables (0.702). In conclusion, both CRP and MetS are independent factors associated with stroke among ethnic Chinese.