Over the past years, the views on the role played by tumor necrosis factor α (TNF-α) in the body have changed. The aim of this review is to provide updates on TNF-α functions in various pathological conditions. While working on the review, the authors made search and analysis of full-text reviews and original articles in foreign (English) and Russian languages using such databases as eLIBRARY.RU, Google Scholar, Web of Science, Scopus and PubMed, mostly from 2018–2022. A priority was given to the original publications. TNF-α is a multifunctional pro-inflammatory cytokine which stimulates the production of other cytokines, chemokines, and interferon γ. Also, it is involved in the inflammatory processes during viral, bacterial, and autoimmune diseases. Its hypersecretion affects lipid, fat, and carbohydrate metabolism; promotes atherogenesis; leads to the development of arterial hypertension, type 2 diabetes mellitus, obesity, and non-alcoholic fatty liver disease; contributes to osteolysis; induces apoptosis of tumor cells in some types of cancer and stimulates metastatic spread and progression in other types. So far, the use of TNF-α inhibitors and the suppression of expression of TNF-α and its receptors has caused disappointment: approx. in 40–50% of cases the inhibition aggravated pathological conditions. The investigation of the cytokine activity is still going on. KEYWORDS: TNF-α, cytokines, inflammation, atherosclerosis, oncogenesis, obesity, diabetes mellitus, adipokines. FOR CITATION: Tereshchenko I.V., Kayushev P.E. Tumor necrosis factor α and its role in pathologies. Russian Medical Inquiry. 2022;6(9):523– 527 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-523-527.