Introduction. Healthcare system of the Sakha Republic (Yakutia) is dealing with complex tasks to deliver medical care in the conditions of harsh climate, difficult transport accessibility, and low population density. Yakutia is the largest district in Russia, covering a wide variance of climatic-geographic zones. More than 40% of its area lies above the Arctic Circle, and the entire territory of Yakutia is included to regions of the Extreme North of Russia. Harsh environment of the Extreme North requires adequate resource allocation and good management of available resources. Aim. Study current capacity and efficiency of healthcare system in the Sakha Republic (Yakutia). Material and methods. For this research, we used data provided by the Territorial body of Federal State Statistics Service in the Sakha Republic (Yakutia) for the period from 2016 to 2020, and mid-year population data (grouped by municipal entities) from the Yakutsk Republican Medical Information and Analytical Center. Analysis was performed using M.A. Tyrylgin’s socio-territorial zoning method (M.A. Tyrylgin, 2008) modified in compliance with the Presidential Decree no. 296 on land territories of the Arctic zone of the Russian Federation (issued May 2, 2014). Results. Over the 5-year study period in the Sakha Republic (Yakutia), positive trend was observed in key regional demographic-health and socioeconomic indicators. Mid-annual population had increased by 15.7 thousand. Readjustments were made in hospital bed capacities and outpatient capacities, as part of planned optimization of medical service, to meet the existing standards and in view of future advent of hospital-replacing technologies. Renewal coefficient for fixed assets was maximal in 2018 (10.0%), and 6.1% in 2020. As a result of optimization, number of medical doctors in Yakutia increased by 6.7%. By the end of 2020, considerable decline in population morbidity was observed (8996 per 10 000 population); decline was observed in each of the disease categories. Over the study period, infant mortality decreased by 29.1% (51.7 per 10 000 newborns in 2020 vs. 73.0 in 2016). As a result of renewal and expansion of fixed healthcare assets, number of equipment and/or medication lack complaints decreased by 23.1% (from 66.2% to 50.9%). Substantial decrease was observed in morbidity due to infectious and parasitic diseases. One of the indicators used to assess quality of care and disease outcomes is disability indicator, which had decreased by 36.6% in Yakutia (35.9 per 10 000 in2020). Discussion. Over the last 5 years in the Sakha Republic (Yakutia), significant shifts took place in healthcare system, including tangible assets expansion, inpatient facilities restructuring, increase in numbers of physicians and nurse personnel, all of which had effect on the quality of medical care. Implementation of high-tech maternal and pediatric medical care, in concert with improved patient routing, resulted in decreased infant mortality. Conclusion. Further analysis of regional healthcare system indicators is required to get complete picture of the efficiency of healthcare system in the Sakha Republic (Yakutia) in challenging circumstances caused by ongoing COVID-19 pandemic and its consequences.