Hypothesis/Aims of study. Obesity and severe chronic somatic pathology in a woman leads to a rapid depletion of compensatory and adaptive reserves of the placenta and to the progression of circulatory and dystrophic changes, which causes intrauterine growth retardation and reduces the likelihood of a favorable course of pregnancy and childbirth. The aim of this study was to assess the morphological features of the vascular component of placental villi in obese women. Study design, materials and methods. histological and immunohistochemical studies were conducted on 41 placentas from obese patients with and without gestational diabetes mellitus and from healthy patients, endothelial marker cD34⁺ expression being assessed in chorionic villi. Results. in obese patients, chronic placental insufficiency is presented in most cases as a dissociated form with persistence of not only mature but also immature villi, which indicates early structural pathology of the placenta. Conclusion. Obesity in women contributes to more frequent chronic placental insufficiency with severe circulatory disorders and varying degrees of severity of compensatory and adaptive changes.