Relevance. Currently, primary health care (PHC) is the most widespread type of medical care, covering the majority of the world's population and forming the basis of health care systems. During the COVID-19 pandemic, the main burden of combating the spread of the disease and preventing mortality fell on the primary health care system. Since the formation of the foundations of PHC in 1978, the principles of PHC have been preserved without losing their relevance, however, approaches to providing assistance have changed and new tools for the development of healthcare have appeared. Purpose: to analyze the formation of PHC and evaluate the trends of its development. Materials and methods: WHO materials; scientific articles on primary health care; legislative and regulatory legal documents were studied. The data (number and supply of doctors and nurses in outpatient and polyclinic settings) of the annual report of Federal statistical observation form No. 30 «Information about the medical organization» in the Russian Federation were used. The results of the study. The article reveals the concept of primary health care as the most important part of the health care system. The article presents the historical aspects of the development of PHC, starting with the Alma-Ata Declaration of 1978. The importance of primary health care as the area of the patient's first contact with the health care system is emphasized. The problems and perspectives of PHC development in the development of healthcare in the Russian Federation are highlighted. The article identifies improvement factors and approaches to the organization of medical care that show increasing relevance. Discussion. The article highlights the main organizational problems of PHC, the development trends caused by them. In the near future, primary health care in the Russian Federation will undergo major change and tools aimed at complying with the principles formulated 45 years ago will be widely used. The tools of long-term development and strategic planning include territorial planning schemes, a process approach in the work of medical organizations providing PHC and solutions based on this approach for the redistribution of functions between groups of personnel and digitalization by improving medical information systems (MIS). Conclusion. The historical importance of PHC (the Alma-Ata Declaration of 1978 and the 2018 Astana Declaration) lies in the fact that it has had a significant impact on the prevailing ideas about health and components, and in many countries it has been adopted as a core element of health policy. As a strong PHC system is the cornerstone of a country's response to health emergencies, the state of PHC systems received special attention from the public, politics, professionals in countries around the world during the COVID-19 pandemic. PHC requires providing affordable and high-quality care for patients, equitable and rational allocation of limited health care resources.