Background: The metabolic syndrome is a major and escalating public-health problem and a clinical challenge worldwide. The increasing prevalence of metabolic syndrome is associated with heart and cerebrovascular diseases. Material and methods: A “case-control” study was performed on 125 subjects that were examined in the Cerebrovascular Diseases Neurology Department of the Emergency Medicine Institute, in the period of March 2015–July 2015. All subjects underwent a complete clinical examination and ultrasound examination of the extracranial carotids. Results: The present study shows that the patients with metabolic syndrome (MS) have values of the intima-media thickness and the internal diameter of the common carotid artery significantly higher than the subjects without the metabolic syndrome (p <0.05). Regarding the relationship between the number of risk factors and the markers of atherosclerotic carotid damage, a strong dependence between the two parameters was observed. Thus, it can be stated that 74% of the IMT variation and 77% of the luminal diameter variation is explained by the variation of the number of risk factors constituting MS. Conclusions: The obtained results, suggest that the cluster of risk factors, the MS constituents are connected with the alteration of the carotid arteries, these changes explain the relationship between the MS and the high risk of heart and cerebrovascular pathologies. In MS the risk of cerebrovascular diseases is multifactorial and its early detection and its treatment can prevent vascular events.