Background: Endothelial dysfunction is an early sign of atherosclerosis, which favors the increase of vascular permeability, activation of mast cells and migration of leukocytes, lymphocytes, macrophages, platelet adhesion, smooth muscle cell proliferation and eventual vasospasm, which together determine a proinflammatory status. Angiogenesis is an important pathogenic element of atherosclerosis in stages of complicated plaques, along with mast cells and macrophages. Histotopographical analysis of the distribution of newly-formed vessels as a feature of angiogenesis, expression of mast cell and macrophage in different types of plaques in different arterial vessels in patients with atherosclerosis and metabolic syndrome complicated by atherosclerosis. Material and methods: We studied 34 patients with cerebral artery atherosclerosis. To determine the expression of mast cells in the affected vessels, we used anti-MCT. Macrophages were identified using specific marker CD-68 and newly-formed vessels respectively through the application of CD-105 (endoglin). results: Assessment of the results was based on the final determination of the density and intensity of reaction, as reflected in the quantitative ratio of the different areas of atheromatous plaques. Stained positive mast cells, macrophages and newly-formed vessels have been found in several types of atherosclerotic plaques, especially in adventitia and in the immediate vicinity of the plaques and subendothelial layers. We found a statistical correlation between the type of plaque and clinical data. conclusions: Immunohistochemical method is efficient for the determination of mast cells, macrophages and newly-formed vessels of atherosclerotic plaques, directly reflecting many important pathogenic factors of atherogenesis in patients with atherosclerosis of the brain arteries.