Introduction. During the COVID–19 pandemic, the World Health Organization clarified the rules for coding and selecting the initial cause of death, which had an impact on morbidity rates, since they include "illness or injury that led to death." The dynamics of the incidence of myocardial infarction and acute cerebral circulatory disorders of the adult population in the subjects of the Russian Federation in the period from 2019 to 2022 was studied. The aim of the study is to study the trends in the incidence of myocardial infarction and acute cerebrovascular diseases of the adult population in the subjects of the Russian Federation during the COVID – 19 pandemic. Materials and methods: the assessment of the incidence of myocardial infarction and acute cerebral circulatory disorders in the Russian Federation for the period from 2019 to 2022 was carried out according to the statistical reference books of the Ministry of Health of the Russian Federation "Morbidity of the Russian population", "Medical and demographic indicators" and forms of federal statistical observation No. 12. Statistical and analytical research methods were used in the work. MSOffice Excel 2010 spreadsheets were used for data processing. Results: The authors havr analyzed the dynamics of the incidence of myocardial infarction and acute cerebral circulatory disorders in the adult population of the Russian Federation during the COVID – 19 pandemic. The results of the study show that in the Russian Federation, the dynamics of the incidence of myocardial infarction and acute disorders of cerebral circulation is characterized by a sharp decrease in indicators in 2020 – 2021 and a subsequent increase in 2022. At the same time, repeated myocardial infarctions continued to decrease. It is established that in 2022 the incidence of myocardial infarction and acute cerebral circulatory disorders was lower than the docoid level (by 3.0 and 7.4%, respectively). In the subjects of the Russian Federation, there was a divergence of trends in the incidence of myocardial infarction and acute disorders of cerebral circulation, and the difference in the maximum and minimum values of indicators was nine and sixfold, respectively. Conclusions: A sharp decrease in the incidence of myocardial infarction and acute cerebral circulatory disorders in 2020 – 2021 has a high probability of correlation with the widespread spread of COVID – 19 in this period, since the rules for accounting for diseases combined with COVID – 19 have their own characteristics. In accordance with the rule of choice of the underlying condition, myocardial infarction and some forms of acute cerebrovascular accident in certain cases should be considered as a complication of COVID – 19. However, complications of the underlying condition are not taken into account in the morbidity statistics. In 2022, at the end of the COVID – 19 pandemic, this conclusion is confirmed by an increase in the incidence of myocardial infarction and acute cerebral circulatory disorders. In 2022, in the regions of the Russian Federation, the maximum and minimum values of the indicator of the total incidence of MI and ONMC of the adult population differ by up to 9 and 6 times, respectively.