Objective: Childhood obesity is a serious public health problem that is often transmitted in adulthood where it is associated with a numerous metabolic diseases wich significantly affect quality of life. The aim of this study was to examine the processes affecting the remodeling of the extracellular matrix in adipose tissue of healthy male children and adolescents depending on their body weight. Methods: During the elective abdominal procedure, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) samples were collected from 75 healthy male and adolescent subjects who underwent elective orchidopexy or hernia repair. Subjects were divided into two groups according to their body mass index Z-score. On the collected samples, analysis of adipose tissue morphometry was performed by histological staining method hematoxylin and eosin and the assessment of fibrosis in extracellular matrix of adipose tissue was performed by Massons's standard trichrome staining method for collagen detection; immunohistochemistry was performed for determining the number of CD163+ cells and detection of crown like structures (CLS); enzyme linked immunosorbent assay was performed for determination of serum adipocytokine levels for - chemerin, visfatin, adiponectin and omentin. Real-time polymerase chain reaction (rtPCTR) was performed for determination of relative gene expression for – interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha (TNF-α), collagen VI subtype alpha 3 (COL6α3) on 20 samples. Results: Overweigth and obese subjects were found to have larger surface area adipocytes in SAT, higher number CD163+ cells in VAT, higher number of CLS in both adipose tissue depots, higher collagen staining in VAT and significantly higher gene expression of COL6α3 in both depots and higher gene expression of IL-8 and IL-6 in SAT. Overweight and obesity was positively correlated with larger surface area in SAT, higher number of adipocytes in VAT, CD163+ cells and CLS in both depots of adipose tissue. Conclusion: In male children and adolescents, obesity can lead to subcutaneous adipocyte hypertrophy, increased collagen deposition in VAT, increase COL6α3 expression and promote changes in macrophage polarization, affect their accumulation, structural stability of the extracellular matrix and the development of inflammation process.