The article discusses the histological component of the metabolic syndrome, reveals the main pathomorphological processes of the gastric wall that accompanies it. The histological features of changes of the microcirculatory channel and glandular epithelium of the gastric mucosa during metabolic syndrome are given. The histological changes of lymphoid formations and features of cellular immune response of gastric mucosal components in patients with metabolic syndrome are characterized. As a result of the analysis of literary sources the following conclusions were formed: 1) the most significant changes in the wall of the stomach during the development of MS are the mucous and submucosal membranes of the cardiac, fundal and portal sections, as the most active layers of the gastric wall in the functional plan; 2) endothelial cell swelling, destruction of superficial mucocytes, destruction of gastric holes, change of permeability and barrier function of the walls of microvessels, spasm and dilation of arterioles, reversible increase of permeability of venules and capillary walls are observed in MS; 3) the characteristic feature of MS is an increase in the number of macrophages and mast cells, which causes the release into the perivascular intercellular substance of plasmocytes and lymphocytes from the gaps of microvessels; 4) since the reaction of the glandular component of the gastric mucosa is a reflection of the compensatory-restorative mechanisms occurring in MS, the most characteristic is the decrease in the number of cardiac exocrinocytes and P-cells, an increase in the number of parietal and goblet cells, EC and EC cells. The reactive changes in exocrinocytes are reflected in the differences in the metric parameters of the external diameter of the gland, the diameter of the lumen, and the height of the epitheliocytes.