Aim To determine the impact of body mass index and the presence of metabolic syndrome (MetS) on cardiovascular disease (CVD) and mortality events in an elderly Tehranian population. Methods A population‐based cohort of 1199 participants aged ≥65 years were followed for a mean of 9.74 years. Participants were stratified according to body mass index categories and MetS status. Cox regression analyses were used to estimate the hazard ratio of CVD and mortality events, given overweight participants without MetS as reference. Result During follow up, 271 CVD events and 239 deaths (106 CVD deaths) occurred. Regarding CVD, multivariate‐adjusted hazard ratios for CVD events in normal weight and obese participants without MetS were 1.21 (95% CI 0.77–1.91) and 1.46 (95% CI 0.64–3.34), respectively, and for normal weight, overweight and obese participants with MetS were 2.07 (95% CI 1.23–3.28), 1.72 (95% CI 1.13–2.62), and 1.53 (95% CI 0.95–2.45), respectively. Corresponding hazard ratios for CVD mortality were 2.08 (95% CI 0.93–4.82), 1.07 (95% CI 0.13–8.78), 3.71 (95% CI 1.55–8.85), 2.42 (95% CI 1.06–5.51) and 3.31 (95% CI 1.39–7.88), and for all‐cause mortality were 1.41 (95% CI 0.9–2.23), 1.33 (95% CI 0.51–3.47), 1.84 (95% CI 1.1–3.09), 1.46 (95% CI 0.93–2.34) and 1.5 (95% CI 0.91–2.56), respectively. In the presence of diabetes in place of MetS, all of the diabetic participants regardless of body mass index category highlighted a significant risk for CVD and mortality events. Conclusion Among the elderly population, the presence of MetS was necessary for exploring the risk of CVD events and its mortality; however, only the normal weight population with MetS had a significant risk for all‐cause mortality Geriatr Gerontol Int 2014; ●●: ●●–●●.