Objectives: The objective of this study is to develop the diagnostic tool to distinguish between cold syndrome (CS) and heat syndrome (HS). Methods: A total of 1,753 subjects were divided into three groups, those are CS group, intemediate group, and HS group, by the mean and standard deviation of the cold heat syndrome differentiation score using 7 point scale consisting of 9 items. Demographic characteristics, diseases history, health status, Mibyeong, syndrome differentiation were analyzed. Results: CS is characterized by women, elderly, and low body mass index. CS has a history of thyroid disease, cataract, depression, osteoporosis, and HS has a history of prostatomegaly. CS receives less social psychosocial stress than HS, and the quality of life associated with health status is lower than HS. CS group has the tendency to be tired, painful, sleepless, dyspeptic and anxious. Conclusions: CS is a set of symptoms associated with decreased energy metabolism and decreased metabolic function, and is more likely to be unhealthy than HS.