Our study aimed to compare the effect of fenofibrate on hemostasis between patients with isolated impaired fasting glucose (IFG) and isolated mixed dyslipidemia and to examine the action of this agent on glucose and lipid metabolism. Twenty-two IFG and 23 mixed dyslipidemic patients were treated for 90 days with micronized fenofibrate (267 mg/day) and were compared with 22 age-, sex- and weight-matched control subjects without lipid and glucose metabolism abnormalities. The lipid profile, fasting and 2-h post-glucose challenge glucose levels, HOMA and glycated hemoglobin as well as the plasma levels/activities of fibrinogen, factor VII and PAI-1 were determined at the beginning and after 30 and 90 days of treatment. Compared to the control subjects, mixed dyslipidemic and IFG patients exhibited increased plasma levels of fibrinogen and PAI-1 as well as increased factor VII activity. Fibrinogen, factor VII and PAI-1 were higher in mixed dyslipidemic than IFG subjects. Not only did fenofibrate improve plasma lipids, but it also increased glucose sensitivity and normalized the IFG- and mixed dyslipidemia-induced changes in coagulation and fibrinolysis. Our study shows that IFG is associated with abnormal hemostasis, which is disturbed to a lesser extent in IFG than in mixed dyslipidemia. Fenofibrate seems to produce a complex beneficial effect on hemostasis in this group of patients.