Introduction. The health of the rural population is an important component of the development of municipal territories, where population decline continues to be recorded in Russia. Goal. Conduct a comparative analysis of trends in the demographic indicators of the rural and urban population of the Russian Federation and the Saratov region. Materials and methods. A comparative analysis of the main indicators of the health of the rural and urban population of Russia and the Saratov region for ten years (2011-2020) was carried out. To determine the statistical significance of the difference in relative values, the Student's coefficient was calculated at p2. Results. As of December 31, 2020, 146,17 million people lived in the Russian Federation, incl. 74,8% (109,25 million people) were people living in urban areas, 25,2% (36,92 million people) - in rural areas. There was an increase in the number of people living in the city, and a decrease in rural residents by 3,6% (3831 thousand people) and 1,5% (525 thousand people). respectively. The distribution by sex among persons is presented as follows: women living in urban areas accounted for 54,3%, men - 45,7%, in rural areas - 51,6%, and 48,4%, respectively. Comparative analysis of the indicators of the reproduction of the urban and rural population in Russia for the period 2010-2020 reflects a statistically significant decrease in the birth rate over 10 years, an increase in the level of general mortality and natural decline in the population. Discussions. A retrospective analysis of the demographic indicators of the urban and rural population of the Russian Federation for 10 years indicates the ongoing urbanization of the population. General demographic indicators in the Saratov region are comparable to those in Russia: people of working age, as in the Russian Federation, make up 56%, of which the urban working-age population is 1020,3 thousand people, rural - 314,4 thousand people. Conclusion. With general negative trends in fertility, mortality, and natural increase, the health indicators of the rural population have a more pronounced negative trend than those of the urban population. Structural disproportions of different age groups are noted: the number of persons born in the period from 2000 to 2010 less by 43% and 59%, respectively, than those born in the period from 1985 to 1995, which determines the predicted decline in the working-age population in a fifteen-year perspective by 10% - 15%. In the next 10–15 years, an increase in the need for medical care is predicted, due to the demographic indicators of the younger and older age groups of the working population.