Abstract. In the Russian Federation, as in most developed countries, the problem of depopulation and population aging is currently quite acute. Objective: to study the medical and demographic indicators associated with the formation of the birth rate dynamics in the Tambov region Material and methods. The main medical and demographic indicators associated with the birth rate in the Tambov region were analyzed based on official statistics from the Unified Interdepartmental Information and Statistical System, collections of the Ministry of Health of Russia and the Federal State Budgetary Institution "TNIIOIZ" of the Ministry of Health of Russia, reporting forms No. 13 "Information on pregnancies with an abortive outcome". Data analysis was carried out using Microsoft Excel - 2016. Results. From 1990 to 2023, the permanent population of the Tambov region decreased by more than 350 thousand people (-36.9%). Natural population decline is due to a decrease in the number of births by almost 2.5 times during the analyzed period. The highest value of the total fertility rate was observed in 1990 - 1.83, in 2023 it decreased to 1.21. The decrease in birth rates in the region is associated with a decrease in the total number of women of childbearing age by 83.6 thousand people, including due to an almost twofold decrease in women aged 15-29 years, a redistribution of age-specific birth rates - their decrease in the age group of women 20-24 years by almost three times, a decrease among women aged 15-19 years, an increase in the birth rate among women in the age group of 25-29 years, 30-34 years and a less intensive growth in the group of women 35-39 years. Infertility is also associated with a low birth rate in the region. From 2008 to 2023, 3,811 women with infertility were registered. Conclusions. Despite the measures taken by the state aimed at increasing the birth rate, the population of the Tambov region continues to decrease, which is due to a decrease in the number of children born. A promising direction for increasing the birth rate is the preservation and restoration of women's reproductive health.