Objective <p>Elevated prolactin levels are considered a potential parameter associated with increased cardiovascular risk. The aim of our study is to investigate the possible role of Endocan levels in the cardiovascular risk associated with hyperprolactinemia by comparing patients with hyperprolactinemia to a healthy control group.</p> Methods <p>The study included 39 patients with hyperprolactinemia of various etiologies and 39 healthy controls. In both groups, cardiovascular risk-related parameters—including height, body weight, BMI, waist circumference, CRP, and lipid levels—were evaluated and recorded. Endocan levels were measured using the ELISA method.</p> Results <p>The groups were comparable in age, sex, height, body weight, BMI, and waist circumference. No significant differences were found between the patient and control groups in terms of height, body weight, BMI, waist circumference, WBC count, fasting glucose, insulin levels, HOMA-IR, HbA1c, lipid profile, CRP, and 25(OH) vitamin D levels. However, serum Endocan levels were significantly higher in the hyperprolactinemic group (<i>p</i> = 0.028). In this group, Endocan levels showed a significant positive correlation with waist circumference, body weight, and BMI, and a negative correlation with WBC count.</p> Conclusion <p>One of the key findings of our study is the elevated Endocan levels in patients with mildly increased prolactin levels (45.90 ± 2.72 ng/mL), indicating a higher cardiovascular risk. This may reflect the association between elevated prolactin and endothelial dysfunction. Further prospective studies with larger sample sizes and longer follow-up are needed to better evaluate Endocan levels in patients with hyperprolactinemia.</p> Clinical trial number <p>No applicable.</p>