The authors studied the peripheral microcirculatory blood flow (MCBF) by means of laser Doppler flowmetry in a total of 112 patients presenting with stage IIB-IV lower limb chronic ischaemia (LLCI) on the background of metabolic syndrome (MS). The study was aimed at assessing the state of the peripheral MCBF in LLCI patients on the background of MS. Atherosclerotic lesion of lower-limb vessels on the background of MS is characterised by more pronounced impairments of the functional state of microcirculation in the form of a decrease in the reserve of capillary blood flow during the occlusion test both before and in the early period after revascularization. Patients with LLCI combined with MS were found to have more pronounced alterations in sympathetic regulation and reactivity of the microcirculatory bed in the form of the paradoxical reaction of the blood flow during the breath-holding test.