Introduction. The high prevalence of metabolic syndrome (MS) necessitates the search for new diagnostic methods that can be easily applied in everyday clinical practice. Ultrasound examination (USE) is a method that allows to evaluate body composition, including visceral (VAT) and subcutaneous adipose tissue (SAT), however, studies of its effectiveness in MS have not yet been conducted. Aim of study — to study body composition in patients with MS using ultrasound. Material and methods. The study included 78 patients: 19 (24.4%) men and 59 (75.6%) women with MS aged 43 to 77 years (mean age 63.7±7.6 years). Patients underwent a standard clinical and anthropometric examination, they underwent laboratory studies, echocardiography, as well as bioimpedance analysis with assessment of the proportion of fatty and lean tissue, skeletal muscle mass and ultrasound with the assessment of VAT, SAT and index VAT / SAT. Results. VAT increased in direct proportion to body weight (with overweight — 89.9 [83.5; 100.3] mm, 1st degree obesity — 118.8 [112.3; 124.4] mm, obesity 2—3 degree — 138.0 [127.8; 156.8] mm). The SAT index was 24.3 [20.4; 27.5] mm, 20.2 [15.3; 23.1] mm and 30.0 [18.3; 34.0] mm, and the index VAT/SAT — 3.6 [3.2; 4.8], 6.2 [5.3; 7.4] and 4.5 [3.6; 8.5] respectively. In women, the VAT index and the VAT/SAT coefficient were statistically significantly lower, and SAT — higher than in men (p<0.05). In patients with MS and HDL levels of ≤1.2 mmol/L, compared with patients with normal HDL levels, the VAT index and the VAT/SAT index were significantly higher, SAT — lower (p<0.05). Conclusions. The composition of the body, determined by ultrasound in patients with MS, is interconnected not only with BMI, but also with sex, lipid levels, as well as the structural and functional state of the myocardium, which must be taken into account when developing programs for the prevention and treatment of this pathology.