Introduction. The state of health of adolescents aged 15-17 reflects not only the current situation in the health care system of the region, but also allows predicting trends in the formation of the incidence of chronic pathology among the adult population. The purpose of the study is to conduct a comparative analysis of the incidence rates of urban and rural adolescents (15-17 years old) of the Karachay-Cherkess Republic in 2021. Material and methods. The state of health of adolescents aged 15–17 years was studied according to the statistical reporting of the Ministry of Health of the Karachay-Cherkess Republic form of federal statistical observation №12 «Information on the number of diseases registered in patients living in the service area of a medical organization» for 2021 Results. According to the data obtained among urban and rural adolescents, the overall incidence rate was 2103.2 and 1180.3 cases per 100 population, the primary level was 1474.6 and 851.5 cases, respectively. Among urban boys, the level of general and primary morbidity significantly prevailed over rural ones (1825.0 and 924.3 cases of general, 1307.6 and 671.6 cases of primary, respectively), as well as among girls (2388.5 and 1447.3 cases general, 1645.9 and 1039.1 cases primary, respectively). Among rural adolescents, compared with urban adolescents, blood diseases, diseases of the digestive system, injuries and poisonings, and ear diseases predominate; for other classes, the incidence of urban adolescents is higher. Among urban adolescents, the first five ranking places in the structure of general morbidity with a total share of 70.9% are represented by diseases of the respiratory system, eyes, nervous and genitourinary systems, and injuries. Slight differences from urban adolescents are observed among rural adolescents in the structure of general morbidity with a total share of 73.9%, while the first five ranking places are represented by respiratory diseases, injuries, diseases of the eye, digestive organs, and the endocrine system. A similar structure of morbidity with a slight difference was typical for urban and rural boys and girls. Conclusions. Among urban adolescents of the Karachay-Cherkess Republic, the level of general and primary morbidity for all classes of diseases is almost twice as high as compared to rural adolescents (by 43.9% and 42.3%, respectively). The level of general and primary morbidity for all classes of diseases among urban boys prevailed over rural boys (by 49.4% and 48.6%, respectively) as well as among girls (by 39.4% and 36.9%, respectively). The results of this study demonstrate the dependence of the level and structure of morbidity on the territorial affiliation of the subject.