The article provides an overview of published data on the state of the problem of combined chronic obstructive pulmonary disease and metabolic syndrome and the results of epidemiological studies on the combination of these nosological forms. The possible pathophysiological mechanisms of mutual worsening of these diseases are discussed. This review emphasizes the role of systemic inflammation, smoking, including passive smoking, as the leading risk factor. It also highlights the importance of determining the phenotype of chronic obstructive pulmonary disease to select the tactics for these patients. The value of adding obstructive sleep apnea syndrome was also considered. The indicated pathogenetic mechanisms that influence components of metabolic syndrome, including type 2 diabetes, on pulmonary function were considered. The article highlights the features of treatment, long-term trends in therapy of these diseases. Refs 46.