Metabolic syndrome (Msmall ie, CyrillictS) is a combination of clinical and laboratory abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes mellitus. Purpose - to detect and identify peculiarities of MetS and its criteria in children depending on gender. MetS was estimated in 89 (5.9%) children from 1520 examined children: in 39 (2.6%) girls and 50 (3.3%) boys (p>0.05) aged from 9 to 18 years. Children were selected for examination of anthropometric data, blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides, fasting glucose and insulin, index HOMA-IR, glucose/insulin ratio and QUICKI. Heart rate variability (HRV) study and echocardiography were done. Diagnosis of MetS was provided according to IDF Consensus (2007). Abdominal obesity was diagnosed in all children with MetS. Boys had essentially more large body mass, height, body surface area, neck and waist circumferences, weight/height ratio than girls (p<0,001). Blood pressure in boys was higher than in girls, arterial hypertention in boys (72,0%) was diagnosed more often than in girls (46,2%). Insulin resistance was identified 1,5 falled more often in girls than in boys (p<0,05). Statistically significant difference in lipid metabolism in boys and girls was not estimated. According to HRV boys had higher activity of the autonomous nervous system than girls. Left ventricular (LV) myocardial mass and thickness of the LV posterior wall in boys were significantly larger than in girls that proved a higher risk of LV hypertrophy and concentric remodeling. Attention to gender differences of MetS must be paid and gender-specific strategies for the prevention of cardiovascular diseases and type 2 diabetes mellitus should be formulated.