Endothelial dysfunction (ED) occurs early in the development of atherosclerosis. Predictors of vascular risk including obesity, hyperlipidemia, metabolic syndrome, diabetes mellitus, and hypertension are associated with both vascular endothelial and ED. Endocan is a novel marker of endothelial dysfunction, inflammation, and atherosclerosis. Raised endocan levels (usually measured by ELISA assays) were reported in some cardiovascular diseases and related conditions. Increased endocan levels may represent the endothelial and inflammatory components of the pathogenesis of ED and may, therefore, prove useful in clinical practice.