Introduction. The analysis and research for opportunities to manage inequality in health, taking into account territorial differences and uneven distribution of health systems resources, play an important place in the national social policy. The problems of preventable discrepancy in health outcomes among children with cancer require the development of new policy options. Oncological diseases in children represent a wide and heterogeneous spectrum of rare cancers. Despite the significant progress made in recent years in improving the survival rate and quality of care for children with cancer, global inequality is significant in most territories. Only 10% of the world's children with cancer live in high-income countries, while the rest of children with cancer experience serious inequalities in access to timely diagnosis and quality medical care. There are also significant inequalities in the WHO European Region as a whole and within countries individually. The study of various aspects of inequality at the national and regional levels provides basis for further effective approaches to organizing affordable and high-quality medical care for children with cancer. Purpose. To conduct a comprehensive analysis of childhood cancer inequality in the European region, including Russian Federation. Material and methods. A content analysis of national and international scientific publications devoted to childhood cancer inequality, as well as underlying mechanisms and ways to eliminate them, was carried out. A total of 78 literature sources were analyzed, including reviews, expert opinions, from which 30 sources were selected, according to the keywords: "Inequality in health care", "Pediatric oncology", "Cancer"; "Healthcare Disparities"; "Childhood Cancer" "Health Services Accessibility" for the last 10 years, which reflect the most pressing issues of inequality affecting the incidence and mortality in pediatric cancer, patient care continuum. Research results. Our review has shown that childhood cancer inequality between high-income and low- and lower-middle-income countries is widely covered by a large group of international experts. However, there is a need to pay more attention to the development of criteria and monitoring of childhood cancer inequalities within individual countries. Currently, there are three main aspects: inequality between countries; inequality within countries; and childhood cancer as a factor of inequality. Inequalities in morbidity, mortality and survival rates can be observed between countries, as well as in the opportunities to access comprehensive medical care, social and financial support for a child with cancer and his family. The factors that cause inequality present an ambiguous picture with different contributions of the determinants of inequality. A more detailed study of the role of individual inequality factors and ways to overcome them, taking into account local peculiarities, is required. Conclusion. Children with cancer still face differences in the availability of specialized medical care, including high-tech, both in outpatient and inpatient settings. Accordingly, there is scarcity of diagnostic, treatment and supportive care capacity which ultimately affects both treatment results and cancer outcomes. The socio-economic determinants of inequality are potentially avoidable with the introduction of a modern model of organization of medical care for children with cancer in the subjects of the Russian Federation.