Objectives. To describe the essential features of the newly established Murmansk County Birth Registry (MCBR); make some preliminary comparisons of selected variables related to pregnancy and delivery in northern counties of the Nordic countries and in cities and towns of Murmansk County [Murmanskaja Oblast (MO)] and explore some research possibilities. Study design. A registry-based cohort study. Methods. The MCBR was established in 005 and registration began on 1 January 006. A registry form draws upon both hospital files and information from the mother. There are 54 major fields consisting primarily of tick-off boxes and International Classification of Diseases (ICD-10) codes. A quality control exercise was conducted in both 2006 and 2007. Results. During 006,8,468 births were registered in the MO (coverage = 98.9%). The proportion of errors was below 1% in both years. Limiting the descriptive statistics to 006, compared to counties of the Nordic counties in the Barents Region, the delivering women in the MO were younger and had fewer and lighter (mean of 00 g) babies. The gestational age was somewhat shorter in the MO than in the Nordic counties and fewer babies had a birthweight above 4,500 g. The perinatal mortality corresponding to a gestational age (GA) of either or 8 completed weeks was higher (p<0.0) in the MO than the Nordic counties in this study. In the MO, the birth rate does not balance the reported increase in death rate. Conclusions. Our study concludes that a medical birth registry of satisfactory quality has been established for the world's largest arctic population. (Int J Circumpolar Health 2008; 67(4):318-334)