Aim. To determine seasonal patterns in the incidence of acute myocardial infarction (AMI) and sudden cardiac death (SCD) among the population of Tomsk city in the period from 2006 to 2015.Methods.Data were obtained from the WHO project “Acute Myocardial Infarction Register”. 9060 cases, including 8383 (92.5%) – AMI and 677 (7.5%) – SCD, were registered within the 10-year follow-up among the inhabitants of Tomsk aged over 20 years old. The weather data were taken from the Tomsk branch of the West Siberian Federal Service for Hydrometeorology and Environmental Monitoring. V.I. Rusanov`s classification was used to identify the days with the contrast weather change.Results.The highest incidence of acute coronary accidents was registered in January with the 11.7% increase the annual average, the lowest incidence - in November with the 7.8% decrease the annual average. Similarly, the highest incidence of MI was registered in January (+10.5%), and the lowest in November (-7.7%). The highest incidence of SCD was registered in January (+ 28.6%), while the lowest - in October (-6.1%). The months associated with increase in the rate of acute coronary accidents in general and MI and SCD have been selected. In 2006 it was October, in 2009 – April, in 2011 – March and in 2012 – January. These months had a large number of days with contrasting weather changes.Conclusion.The most unfavorable months in the period from 2006 to 2015 associated with the development of acute coronary accidents were January and May. Days with contrasting weather changes contributed to the increase in the incidence of acute coronary accidents. The determined patterns should be taken into account when planning the delivery of care to patients with acute coronary pathology.