The purpose of this study was to investigate the effects of aquatic and land exercise on atherosclerosis indices and inflammation response markers in elderly with metabolic syndrome man and woman. For subjects of this study, total 48 elderly with metabolic syndrome (male ACEG; 12, male LCEG: 12, female ACEG: 12, female LCEG: 12) that satisfies the NCEP-ATP III criteria seeking treatment at C hospital located in I megalopolis. Subjects in aquatic and land complex exercise group performed their assigned exercise 120 min/day, 3~4 day/week for 12 week. The results of this present study were as follows: In atherosclerosis indices, male had significant difference between pre and post 12 weeks aquatic and land complex exercise program, but aquatic exercise group for the LDL-C/HDL-C factor showed affirmative results more than that land exercise group. And female had significant difference between pre and post 12 weeks aquatic and land complex exercise program, but aquatic exercise group for the T-C/HDL-C, LDL-C/HDL-C and TG/HDL-C factor showed affirmative results more than that land exercise group. In inflammation response markers, male had significant difference between pre and post 12 weeks aquatic and land complex exercise program, but aquatic exercise group for the WBC, CRP and fibrinogen factor showed affirmative results more than that land exercise group. And female had significant difference between pre and post 12 weeks aquatic and land complex exercise program, but aquatic exercise group for the CRP and fibrinogen factor showed affirmative results more than that land exercise group. It was concluded that elderly with metabolic syndrome were improved by exercise training of aquatic exercise program was more effective for enhancing daily living fitness.