Introduction. A significant part of the pathology of the Russian population, as well as most countries of the world, is associated with diseases of the circulatory system (DCS). At the same time, the problems associated with the functioning of regional medical care systems for patients with DCS are widely discussed in the research of domestic authors. The first level of medical care in the framework of regional healthcare is insufficiently developed, due to the low provision of medical personnel to the population, insufficient development of the material and technical infrastructure of medical institutions. Purpose: to present a modern description of the activities of the cardiology service to the adult population using the example of a large city. Materials and methods. The scientific basis of the study was the medical organization of the Samara Region, Novokuibyshevskaya Central City Hospital, which serves the population of a large city, Novokuibyshevsk, with an average annual population of 101.4 thousand people. The indicators characterizing the activity of the cardiological service for the provision of specialized medical care to the adult population from the BSK of Novokuibyshevsk from 2019 to 2023 have been analyzed. The official information of the Territorial State Statistics Body for the Samara region (Samarstat), the reporting forms of the Federal Statistical Office: No. 30 "Information about a medical organization", No. 14 "Information about the activities of medical organization units providing medical care in inpatient settings", analytical materials of the annual reports of the NCGB in dynamics. Results and discussion. In outpatient settings, the cardiology department of the hospital is represented by cardiology rooms, which are part of the polyclinic unit (hospital unit), in inpatient settings – by the cardiology department, which is part of the hospital unit (round-the-clock hospital) of the hospital. Over the period 2019-2023, there has been a slight decrease in the number of occupied positions by 3.4%, and a decrease in the number of individuals of cardiologists by 16.7%. As a result, the ratio of part-time work among this category of doctors is growing from 1.21 to 1.40 (by 15.7%). At the same time, the provision of cardiologists to the adult population by individuals is decreasing from 6.9 doctors per 100,000 population to 6.0. Problems with the staffing of cardiologists in the city hospital are compensated by the work of internists, whose provision (by individuals) has increased slightly from 46.2 doctors per 100,000. the adult population in 2019 increased to 47.9 in 2023 (by 3.7%). The number of visits to cardiologists (in the clinic and at home) per employed person increased from 4,793 to 7,102. There has been an increase in the number of patients with all diseases of the circulatory system under medical supervision per 1,000 adults from 320.3 to 383.6 per 1,000 adults. The completeness of outpatient follow-up of patients with DCS in the NCGB as a whole increased slightly from 66.2% in 2019 to 68.9% in 2023. The number of specialized cardiac beds for adults decreased from 43 in 2019 to 36 in 2023 (by 16.3%), and the number of bed days spent by patients in these beds decreased from 14,014 to 12036 (by 14.1%). The rate of hospitalization of adult patients in the Department of cardiology decreased from 19.1 per 10,000 inhabitants to 15.9 (by 16.8%). With the reduction of the bed stock, the indicators of the use of cardiological beds in 2023 are at a fairly high level, characterized by an intensive therapeutic and diagnostic process (the average occupancy of a bed is 334.3 days, the turnover of a bed is 37.0, the average length of stay in a bed is 9.0 days). Conclusion. As part of the activities of the cardiology service to provide specialized medical care to adult patients with BSC in a large city, there is an insufficient provision of cardiologists to the population, an increased burden on them in outpatient settings, and a decrease in the level of hospitalization of patients in inpatient settings. The volume of specialized medical care for patients with CSC is compensated by the provision of medical care by district internists, the maintenance of an intensive treatment and diagnostic process in the hospital, and the optimization of patient routing with an emphasis on providing specialized medical care in large regional cardiological medical organizations.