Relevance: The train drivers are responsible for the safety of transported people and goods. Therefore, medical monitoring of their state of health is an integral part of ensuring the safety of railway traffic.Purpose: to study the possibilities of using a pulsogram for analyzing the parameters of heart rate variability during pre-trip health examination of members of train crews.Materials and methods: 183 male train crew members (106 engine train drivers, 77 train drivers’ assistants) were examined; the average age was 37.7 ± 9.4 years. ECG and pulsogram were measured simultaneously, and heart rate variability was analyzed.Results: A high degree of coincidence of mean values and variances of heart rate variability parameters, calculated on the basis of ECG (electrocardiogram) and pulsogram, was found. A high degree of reliable positive correlation was established between these parameters. Significant differences in the parameters of heart rate variability were revealed between the members of train crews who underwent and those who did not undergo the first-time pre-trip medical examination.Conclusion: Measurements of heart rate variability parameters based on the pulsogram can be used to solve a number of urgent problems of pre-trip medical examination of members of train crews.