Some pathological conditions including shock, induce focal activation, degeneration, necrosis and desquamation of endothelial cells. These changes cause disturbances of endothelial functions which include expression of adhesive molecules resulting in rolling of the leukocytes along endothelial surface, loss of endothelial adhesiveness to subendothelial matrix resulting in cell desquamation, dysfunction of endothelial anticoagulation/coagulation balance and disturbances of endothelial vasomotor abilities. Above mentioned imbalance of endothelial functions are discussed in aspects of shock.