The endometrium is a unique tissue of the female body that undergoes significant remodeling processes during one menstrual cycle and repeated throughout the life of a woman. Remodeling of any tissue primarily concerns changes in the extracellular matrix and the exchange of its structural components. The exchange of structural components of the extracellular matrix is under the complex control of neuro-endocrine regulation at the transcriptional and post-transcriptional levels. The main «tool» for remodeling is matrix metalloproteinases, which are enzymes that provide tissue remodeling in normal and pathological conditions. The balance between the processes of destruction and the formation of extracellular matrix components plays a large role in the pathogenesis of many diseases, including reproductive organs and the endometrium in particular. Excessive destruction of the structural components of the extracellular matrix leads to tissue degradation, and their excessive accumulation to fibrosis. The article provides up-to-date data on the structure of the extracellular matrix, its components, regulatory mechanisms, and the role of matrix metalloproteinases (MMPs) in them. The extracellular matrix, its structural components, and matrix metalloproteinases are considered as participants in many physiological and pathological processes, including cyclically occurring processes in the endometrium.