AIM: To study epidemiology of acute coronary conditions (ACC) including acute myocardial infarction (AMI) and acute coronary failure (ACF) among female population of Tomsk aged over 20 years and trends for 5 years. MATERIAL AND METHODS: 1919 ACC episodes were compared in the women: 1616(84.2%) cases of AMI and 303(15.8%) cases of ACF. The comparison concerned epidemiological indices: morbidity, hospital and prehospital ACC lethality, the disease history, pathomorphological evidence. RESULTS: ACC prevalence among women for 5 years remained at the level 2.0-2.2 cases per 1000 women of the same age. Number of ACC patients with progressive angina decreased while number of cases of cardiogenic shock went up in paralled decrease of the number of episodes of acute left ventricular failure, arrhythmia and abnormal conduction. AMI as macrofocal occurred more frequently, ACC hospital lethality rose (due to more cases in patients over 60). Autopsy showed more cases of stenosing atherosclerosis of coronary arteries. CONCLUSION: No changes for the better occurred for 5 years among female population of Tomsk in relation to ACC incidence and mortality. This necessitates introduction of measures of effective primary and secondary prevention of ischemic heart disease and arterial hypertension.