Introduction. The relevance of studying the epidemiology of malignant kidney neoplasms among the population of the Russian Federation is due to the persistent increase in the incidence and the remaining high mortality. Objective. To analyze the primary incidence of malignant kidney tumors in the population of the Sakhalin Region in comparison with data from the Far Eastern Federal District and the Russian Federation for the period from 2012 to 2023. Materials and Methods. Over a 12-year period, the statistical form of federal statistical observation No. 7 of the Sakhalin Region, the Far Eastern Federal District, and the Russian Federation, as well as the data from the Cancer Registry of the Sakhalin Region, were analyzed. Results. From 2012 to 2023, the incidence of primary malignant neoplasms of the kidney increased in the Sakhalin Region by 77.4%, in the Far Eastern Federal District by 79.7%, and in the Russian Federation as a whole by 31.4%. A comparative analysis revealed that the studied indicators in the Sakhalin Region significantly exceed those in the Far Eastern Federal District and the Russian Federation over a 12-year period. In 2023, the maximum peak of primary kidney cancer incidence was recorded in the Sakhalin Region, with 30.50 cases per 100,000 population, placing the region second in the ranking among all constituent entities of the Russian Federation, behind only the Murmansk Region, with 32.09 cases per 100,000 population. Discussion. According to Alekseeva G.I. (2021) and Kaprin A.D. et al. (2024, 2025), the population of the Sakhalin Region is at high risk of developing malignant kidney tumors, which is consistent with the results of our study. Conclusion. The dynamics of primary kidney cancer incidence in the Sakhalin Region from 2012 to 2023 demonstrate a steady increase. When conducting a comparative analysis over a 12-year period, it is noteworthy that the increase in the primary incidence of malignant kidney tumors in the Sakhalin Region (77.4%) and the Far Eastern Federal District (79.7%) significantly exceeds the rates in the Russian Federation (31.4%). As part of the implementation of cancer control programs, the trend towards a higher increase in the primary incidence of malignant kidney tumors in the Sakhalin Region may indicate the early detection of kidney tumors and provide an opportunity for timely specialized treatment.