Objective · To investigate the association between neck circumference (NC) and cardiovascular risk factors among middle-aged and elderly people without diabetes in Jiading District in Shanghai. Methods · A cross-sectional study was conducted among 4 657 nondiabetic inhabitants aged 40 and above in Jiading District, Shanghai from August 2014 to July 2015. Clinical information collection, anthropometric measurements, and biochemical analyses were performed. The objects were divided into 4 groups according to the quartiles of NC in order to analyze association between NC and cardiovascular risk factors. Results · With increase of NC, the prevalences of abdominal obesity, insulin resistance, hypertension, and dyslipidemia all increased as well as waist circumference, body mass index (BMI), blood pressure, lipid profile, fast blood glucose, and HOMA-IR level (all Ptrend <0.01). Multiple Logistic regression analysis showed that individuals in Q2, Q3 and Q4 group had significantly higher risk of abdominal obesity, insulin resistance, hypertension, and dyslipidemia compared with those in Q1 group after age, sex, smoking, drinking, physical activity, BMI, waist circumference, systolic blood pressure, C-reactive protein, fast blood glucose, and lipid profile were corrected (all Ptrend <0.01). Conclusion · NC is positively and independently correlated with cardiovascular risk factors in middle-aged and elderly nondiabetic people in Jiading District in Shanghai.