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Introduction. Childhood obesity is one of the most pressing problems in modern pediatrics. The serious attention of specialists is attracted by numerous reports on changes in the composition of the intestinal microbiota (IM) in obese patients. А im. Тo find the relationship between the metabolic complications of obesity in children and the diversity of IM. Materials and methods. A single-stage prospective controlled study was conducted, which included 133 children with exogenous constitutional obesity and 23 healthy children of the control group. All children underwent an examination aimed at diagnosing metabolic complications of obesity. An additional research method was the assessment of the microbiome of the luminal contents of the large intestine with the identification of microorganisms by MALDI-ToF mass spectrometry. Results. The study revealed a high incidence of metabolic complications of obesity in the examined patients: arterial hypertension (AH, 22.7%), impaired carbohydrate metabolism or type 2 diabetes mellitus (25.1%), dyslipidemia (25.6%), impaired purine metabolism (46.4%) and metabolically associated fatty liver disease (49.3%). When assessing the microbiological profile, a decrease in the frequency of excretion of bifidobacteria and streptococci in patients with hypertension was revealed, and the relationship of individual microorganisms with some complications of obesity was also found. Discussion. According to the literature, the frequency of excretion of bifidobacteria in obese patients is reduced, as in our case. This can be considered as a potential therapeutic target for the correction of metabolic disorders. The issue of reducing the diversity of IM in patients with hypertension is also being discussed in the scientific community, which this study also shows, proving the relationship of changes in IM with complications of obesity. It turned out to be interesting that certain bacteria associated with colorectal cancer were isolated from obese patients, which requires further study of the issue, given the higher prevalence of oncopathology in this group of patients. Conclusions. The results of the study demonstrate a high incidence of metabolic complications of obesity in children, as well as their relationship with IM, which dictates the need for further study of this area and the search for possible ways to influence IM in order to influence metabolic disorders in obese patients.