Abstract:Metabolic syndrome (MetS) is a chronic non-infectious disease clinically characterized by a cluster of cardiovascular risk factors including insulin resistance, hypertension, abdominal obesity, impaired glucose metabolism, and dyslipidemia. The incidence of MetS is currently increasing dramatically and has become a global issue. Systemic defects in autophagy exacerbate MetS, while traditional Chinese medicine (TCM) can synergistically regulate cellular autophagy through multiple pathways, targets, and mechanisms. Thus, how to effectively prevent and treat MetS based on autophagy pathways has become a hot research topic in this field. This review outlines the process and mechanism of cellular autophagy, focusing on its relationship with the major pathological mechanisms of MetS, and summarizes the preventive and therapeutic effects of Chinese herbal formulas and their active ingredients on MetS through the cellular autophagy pathways based on the theories of modern medicine and the perspectives of TCM, thereby providing novel insights to promote the integration of TCM and Western medicine to prevent and treat MetS.