Objective. Comprehensive ultrasound assessment of the state complex intima-media (CIM) of brachiocephalic arteries in patients with metabolic syndrome (MS). Materials and methods. 82 patients were examined, including 62 patients with MS and 20 practically healthy individuals. All patients underwent biochemical blood analysis, ultrasound of the extracranial sections of the brachiocephalic arteries with an assessment of the qualitative and quantitative characteristics of CIM bifurcation of the brachiocephalic trunk (BCT), common carotid arteries (CCA) and vertebral arteries (VA).Results. 100% of patients with MS, changes in the echostructure of CIM were recorded in the form of pathological layering, 9 (14.5%) patients – in the form of hyperechogenic inclusions. Thickness of CIM in the bifurcation of BCT and CCA in patients with MS statistically significantly exceeds the same indicator in practically healthy persons and demonstrates direct correlation between the components of MS. The modified Carnegan index patients with MS is statistically significantly higher than the same indicator in practically healthy individuals and demonstrates direct correlation with the thickness of CIM estimated in different segments of the brachiocephalic arteries (BCT k 0.356, RCCA k 0.718, LCCA k 0.846, in the bifurcation of CCA on the right k 0.431, on the left k 0.519).Conclusion. Comprehensive ultrasound assessment of the state brachiocephalic arteries in patients with MS allows us to obtain complex of qualitative and quantitative signs characteristic of metabolic angiopathy.