Metabolic syndrome (MS) is a cluster of several risk factors such as abdominal obesity, hypertension, dyslipidemia, insulin resistance and considered risk for the development of the type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Knowing contemporary aspects of the development of this disease allows understanding underlining mechanisms of the MS. This review summarizes modern concepts of the metabolic syndrome and its etiology, pathogenesis and biochemical mechanisms of the development of the metabolic disease.