The epidemic transition is the most important part of the demographic transition, which in turn determines the current trends in fertility and mortality in modern Russia. The paper attempts to trace the main regional features of the process by the example of the Middle Volga Region. Using the statistics reported in the census, statistical handbooks, central and local archives, the author traces the changes in morbidity and mortality of the urban population of the Middle Volga Region, making the conclusion that the epidemiological transition in the region was essentially completed in the period of the Khrushchev thaw. There was also a rapid increase in mortality from malignant neoplasms and circulatory diseases, which is characteristic of the final stage of the epidemic transition. The author of the paper revealed some lag of the region in terms of exogenous morbidity. It was associated with the rapid growth of industry in the region, and as a consequence, not always appropriate conditions of hygiene and life of the urban population. However, mortality trends in the Middle Volga Region corresponded to those in the RSSR as a whole, which was primarily due to the achievements of medicine of the time: the emergence of antibiotics, mass vaccination of the population, improving the quality of medical services.