Background. Chronic pancreatitis is one of the most common diseases in general therapeutic practice. Significant role in the onset and progression of chronic pancreatitis is played by the activation of the kallikrein-kinin system (KKS), which is involved in the development of inflammation, blood coagulation and fibrinolysis, immune responses, the formation of pain, etc. Objective: to investigate the dynamics of indicators of the kallikrein-kinin system when using metadoxine in the comprehensive therapy of patients with chronic biliary pancreatitis associated with obesity. Materials and methods. 75 patients with chronic biliary pancreatitis combined with obesity were examined. They were divided into 2 groups. The first group (30 people) received the standard treatment. The second group (45 people) received the standard treatment and metadoxine. Results. Analyzing the results, it has been found a reliable positive dynamics of KKS indices in both groups after the treatment. However, patients in the second group showed a more significant positive dynamics of KKS parameters: the level of proteolytic activity has decreased by 9.0 %, the kallikrein — by 20.0 %, a1-proteinase inhibitor — by 7.2 %, and prekallikrein has increased by 6.4 %, a2-macroglobulin — by 10.8 %, kininase II — by 10.7 % as compared to group 1. Conclusions. The use of methadoxine in the comprehensive therapy of patients with chronic biliary pancreatitis associated with obesity contributed to a significant increase in the effectiveness of conventional treatment.