OBJECTIVES: To estimate cost-effectiveness of the vaccination program with quadrivalent Human Papillomavirus (HPV 6, 11, 16, 18) recombinant vaccine for  the prevention of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC) in Russian health care. METHODS: Cost-effectiveness analysis of vaccination program vs no vaccination was performed. The previously published model (R. Insinga et al.)  was adjusted for Russia. Rates of CIN and CC were simulated with and without vaccination in a cohort of girls 12-13 years old. Time-horizon  was 24 years. 100% vaccination coverage was assumed. Direct medical costs were estimated. Outcomes measured were: the cost of averted CIN case and the cost per additional life-year saved. RESULTS: The cost of introducing HPV vaccination program with 100% coverage of the target audience of 12-13 years old girls  is 408,16 mln € (16,282,34 bln rubles). In the absence of vaccination the costs of providing medical care to patients with CIN and CC are 160,027 mln € (6, 36 bln rubles). Therefore the  overall costs in a vaccinated cohort were 481,14 mln € (16,285,25 bln rubles). HPV vaccine prevents 408 469 cases of precancerous cervical lesions. Due to HPV vaccination the incidence of CC  is reduced by1858 cases, which corresponds to 31 588 years of life saved in the vaccinated cohort. The cost of an additional life-year saved is 10,166 € (405,535 rubles), and the cost of averted CIN case is 786 € (31,360 rubles). CONCLUSIONS: Vaccination with Human Papillomavirus recombinant vaccine seems a cost-effective option in Russia.