Metabolic syndrome is a set of diseases consisting of obesity, hyperglycemia, hypertension, and dyslipidemia, each of which can affect bone tissue. Data from various studies demonstrate the presence of common main pathways, including regulation of calcium homeostasis, ligand-receptor activator, and osteoprotegerin. The high prevalence of metabolic syndrome and osteoporosis in menopausal women, and contradictory data on the relationship between both conditions indicate the importance of further study and discussion of this topic. We suggest that metabolic syndrome may play a potential role in the development of osteoporosis in menopausal women. Two hundred and ten patients took part in this scientific research. Bone metabolism in menopausal women with metabolic syndrome was evaluated using various methods of examination. Menopause is an independent predictor of the development of metabolic syndrome. Metabolic syndrome and its components are also risk factors for a decrease in bone mineral density. As a treatment and prevention of menopausal metabolic syndrome, therapeutic measures should be aimed at achieving metabolic control, normalization of total body weight, and increased physical activity.