Aim. The aim of the work was to describe hematological biochemical parameters of blood and sympatho-vagal balance in elite (IMS, n = 12) and highly skilled swimmers (CMS, n = 23). Materials and methods. Hematological (n = 10) and biochemical (n = 11) parameters were determined with automatic analyzers from venous blood. The autonomic regulation of the heart was assessed by means of spectral analysis. Results. IMS swimmers had increased levels of RBC (+ 12.5 %, p < 0.01), Hb (+ 10.2 %, p < 0.01), MCHC (+ 9.7 %, p < 0.01) and Ht and decreased levels of MCV (–4.0 %, p < 0.01) and Leu (–17.4 %, p < 0.01) compared with the control group. CMS swimmers had decreased levels of MCV (–2.0 %, p < 0.05) and Lym (–19 %, p < 0.01) but increased levels of МСНС (+2.5 %, p < 0.05). Both groups of swimmers had decreased levels of IgM, IgA, triglycerides, glucose and increased levels of HDL-C. Elite swimmers had lower fibrinogen levels than those of the control group. In IMS athletes, LF/HF was increased (p < 0.01) and %HF was decreased (p < 0.01) compared with CMS athletes. However, the abovementioned values were similar to those of the control group. Conclusion. The functional status of elite swimmers at the end of the preparatory stage is characterized by moderate hemoconcentration, decreased MCV values, decreased inflammatory activity and increased sympathetic tone in heart rate regulation.