The review represents comparative data on the biological effects of inorganic (HTO) and organic (OBT) compounds of tritium at the molecular, cytogenetic and system levels. The data of the relative biological effectiveness (RBE) of OBT and HTO depending on their distribution in the cells and tissues of the body are presented. Experimental studies show that the calculation of the RBE of tritium compounds at different levels of organization leads to contradictory data. Such observation is associated with the interaction both of HTO and OBT with critical biomolecules in the cells as well as the proliferative activity of different cells and tissues. The experiments revealed that the effectiveness of OBT is much higher than the HTO which is associated with their rapid inclusion in the critical biomolecules such as proteins and DNA with the further formation of a significant biological effect. Based on the recently obtained data in different laboratories on the effect of tritium compounds at the molecular and cellular levels, it is concluded that a new approach for HTO and OBT risk assessment is necessary.