Aim. To comprehensively study hemostasis pathology and its association with the laboratory markers and mediators of inflammation in patients with metabolic syndrome (MS). Subjects and methods. One hundred and eleven patients with type 2 diabetes mellitus, who were diagnosed as having MS, were examined. Vascular-platelet and secondary hemostases and anticoagulant and fibrinolytic systems were evaluated, by performing the complete clinical, laboratory, and instrumental study accepted in a specialized endocrinology clinic. The blood concentrations of high-sensitivity C-reactive protein and proinflammatory cytokines were determined in all the patients with MS and control persons (n=50). Results. It was found that in patients with MS, hemostasis pathology that might be classified as the combined form of a prethrombotic state, which was caused by different types of a constellation of vascular-platelet and plasma hemostases, as well as physiological anticoagulant deficiency, was linked to the laboratory markers and mediators of subclinical inflammation. Conclusion. In the patients with MS, subclinical systemic inflammation is of substantial importance for the mechanisms of a prethrombotic state.