Discovered two decades ago, endocan still represents an intriguing biomarker related to inflammation. Endocan is a soluble dermatan sulphate proteoglycan secreted by endothelial cells. Its expression is observed in tissues related to the enhanced proliferation, especially hepatocytes, lungs, kidneys, etc. Endocan has been investigated in many cardiometabolic disorders that are tightly connected with inflammation, such as type 2 diabetes mellitus, hypertension, atherosclerotic cardiovascular disease, kidney disease, obesity, polycystic ovary syndrome, metabolic syndrome, non-alcoholic fatty liver disease, etc. In this narrative, comprehensive review of the currently available literature, special attention will be paid to the role of endocan in the broad spectrum of cardiometabolic disorders. Since endocan has emerged as a novel endothelial dysfunction marker, the discovery of potential therapeutic strategies for patients with certain cardiometabolic risk factors would be of great importance to delay or even prevent the onset and progression of related complications, mainly cardiovascular.