Objective To investigate the association of metabolic syndrome and its components with gallstones and the factors for the development of gallstones. Methods A total of 445 community residents, who were followed up by Department of Endocrinology in The First Affiliated Hospital of China Medical University from January to June, 2015, were enrolled as study subjects and were divided into metabolic syndrome group with 220 patients and non-metabolic syndrome group with 225 patients. A questionnaire survey, physical examination, and blood test were performed for these patients to obtain the data on sex, age, body height, body weight, waist circumference, blood pressure, and blood biochemical parameters [fasting blood glucose, triglyceride (TG), and high-density lipoprotein (HDL)]. The chi-square test was used for comparison of categorical data between two groups, the t-test was used for comparison of continuous data between groups, and a multivariate logistic regression analysis was used to identify independent risk factors for the development of gallstones. Results Of all patients, 49 (11.01%) had gallstones, among whom 38 (17.27%) were in the metabolic syndrome group and 11 (4.89%) were in the non-metabolic syndrome group; the metabolic syndrome group had a significant increase in the prevalence rate of gallstones (χ2=17.409, P<0.001). The multivariate logistic regression analysis showed that increased waist circumference (OR=1.088, P<0.001), increased TG level (OR=1.209, P=0.038), and reduced HDL level (OR=0.329, P=0.014) were independent risk factors for gallstones. Conclusion Increased waist circumference, increased TG level, and reduced HDL level may be independent risk factors for the development of gallstones. [ABSTRACT FROM AUTHOR]