One qi circulation is a classical theory of traditional Chinese medicine(TCM).According to this theory，the qi in spleen and stomach is the hub of qi movement around the whole body.The deficiency of spleen and stomach and stagnation of liver qi lead to the transportation and transformation disorders of water and grain and the obstructed qi flow，the lingering of which causes the accumulation of phlegm and stasis in the blood vessels and further vascular endothelial injury in metabolic syndrome.Clinical trials have confirmed that Chaiqi Decoction with the effects of invigorating spleen and soothing liver can ameliorate metabolic syndrome and related vascular endothelial injury.Pyroptosis，a pro-inflammatory programmed cell death，plays a key role in vascular endothelial inflammation.This process is similar to the accumulation of phlegm，stasis，turbidity，and toxin in TCM.Based on the theory of one qi circulation，this paper elaborates on the mechanism of pyroptosis and vascular endothelial injury in metabolic syndrome，aiming to provide a theoretical basis for the prevention and treatment of vascular complications in metabolic syndrome with TCM.