AIM To study the role of hypothyroidism and concomitant obesity in the development of metabolic syndrome (MS). MATERIAL AND METHODS We examined 60 women suffering from obesity and hypothyroidism (TTH 22.24 +/- 4.031). We studied lipid spectrum, carbohydrate metabolism, BP and insulin resistance, fat tissue distribution, exercise tolerance. RESULTS According to IDF (2005) criteria the women had: metabolic syndrome (83.4%), newly diagnosed hypothyroidism (95%), decompensated hypothyroidism (90%), subclinical hypothyroidism (65%) after six-month replacement therapy with L-T4 MS symptoms declined. CONCLUSION Abnormally high level of TSH may be a component of metabolic syndrome.