Objective To investigate the prevalence and risk factors of metabolic syndrome(MS)in perimenopausal women in Zhejiang province.Methods 3,553 perimenopausal women aged 40~60 who underwent health examinations from October 2018 to October 2021 were selected.They were divided into two groups based on the occurrence of metabolic syndrome.The demographic data,physical measurement indicators,blood biochemical indicators,ultrasound examination results,and lifestyle questionnaires of the two groups were compared.Results The incidence of metabolic syndrome in perimenopausal women is 20.0% .There were significant differences in pregnancy hypertension,pregnancy diabetes,age,body mass index(BMI),menarche age,diet taste,fruit intake between the metabolic syndrome group and the non-metabolic syndrome group(P<0.05).Logistic regression analysis showed that age≥50 years,BMI≥24 kg/m2,menarche age≥12 years,salty diet,long sleep time,menopause,pregnancy induced hypertension and pregnancy induced diabetes were independent risk factors for the occurrence of metabolic syndrome in perimenopausal women(P<0.05).The ROC curve showed that the area under the ROC curve(AUC)for age,menarche age,and BMI were 0.668,0.624,and 0.779,respectively.Conclusion Age,BMI,age at menarche,salty diet,sleep time per night,menopause,pregnancy diabetes and pregnancy hypertension are the influencing factors of metabolic syndrome in perimenopausal women.Appropriate intervention of various influencing factors has important significance for the prevention of metabolic syndrome in perimenopausal women.