OBJECTIVES: To study the economic burden of cardiovascular diseases (CVD) in Russian Federation in 2006-2009. METHODS: The economic burden was calculated by the cost of illness method. The calculations included direct costs of healthcare system and indirect costs, associated with premature death in working age and disability.  We used official statistics of healthcare resources utilization, associated with CVD (hospital days, outpatients visits, emergency visits), the results of pharmacoepidemiological surveys of CVD, mortality and disability statistics in Russia in 2006-2009. RESULTS: The total economic burden of CVD increased from 20.6 billions of euro in 2006 till 26.6 billion of euro in 2009 what was equal to 3.1-2.8% of GDP of Russian Federation.  The increasing of the burden was mainly caused by the price increasing and in some degree by the increasing of PCI in CHD patients in recent years. Direct costs accounted 21.3% of total cost of CVD (5.7 billions of euro), indirect costs – 78.7% (20.9 billions of euro) in 2009. Indirect costs mainly consisted of the GDP losses because of premature death of working age men. CHD represented 37.8%, cerebrovascular diseases 17.1 % and hypertension -10.8% of overall CVD costs. In-hospital care represented 47.5% of direct costs, outhospital visits – 21.8%, medication – 20.7%, PCI – 4.1% and emergency care 4.1% of direct costs in 2009, respectively.  CHD represented 45.3% of direct cost, because of large duration of hospitalization and PCI costs. CONCLUSIONS: CVD is a big public health challenge in Russia. The results of economic burden assessment should help policy makers evaluate policy impact and prioritize expenditures.