Abstract: Objective To determine component changes of metabolic syndrome in pre-elderly people with healthy obese phenotype. Methods A total of 1 686 adults aged between 45-59 yr. who underwent health examinations from 2010 to 2016 in West China Hospital of Sichuan University participated in this study. The participants had healthy obese phenotype at the baseline but no history of diabetes, high blood pressure, high cholesterol and cardiovascular disease. Component changes of metabolic syndrome (MS) and associated factors over the seven-year period were analysed using logistic regression modeling. Results The number of MS components increased over the years in centrally obese individuals, and 11.0% developed MS, including 118 men 〔(53.29±4.00） years old, 66.95% current smokers, 5.93% past smokers, 24.58% alcohol drinkers〕 and 67 women 〔(52.01±4.06） years old, 26.87% current smokers, 1.49% past smokers, 11.94% alcohol drinkers〕. The most frequently presented MS components included higher fasting glucose, higher blood pressure and higher triglyceride. Healthy status (0 MS component) resumed in 44 participants who had abdominal obesity (1 MS component) at the baseline: 27 women and 17 men. Age (OR=1.732，95%CI：1.594-1.882，POR=7.188，95%CI：4.311-11.986，POR=3.986，95%CI：2.283-6.959，P<0.000 1) were identified as risk factors of MS. Conclusion MS components increase over years in both men and women. Smoking and drinking are the main risk factors of MS progression. Regular MS surveillance and behavioral interventions are recommended for pre-elderly people with healthy obese phenotype.