Since metals industry regions are dependent on the location of production resources and infrastructure, as well as have highly capital-intensive production, they usually feature a slowly changing industrial and technological structure of production. In line with the hypothesis of the study, the technological structure of the manufacturing industry determines the differences in their economic development. The study aims to explore the medium-term trends and patterns in economic and technological development of the metals industry regions. The methodological basis of the research is the structural dynamic approach to studying regional economic development. The methods include multivariate data analysis and clustering algorithms, time series estimation and correlation analysis. The study uses the data on large and medium-sized enterprises by types of economic activities for 2006–2021 taken from an information and analytics system FIRA PRO. According to the findings, the Chelyabinsk, Sverdlovsk, Lipetsk, Vologda and Tula oblasts are metals industry regions. The identified medium-term trends in their economic development show different dynamics of input and output indicators of production both by all types of economic activities and in metals industry in particular. The study proves that the dynamics of metals industry regions’ development largely depends on technological characteristics of the manufacturing industry. The results of the research contribute to the understanding of the adaptation mechanisms of regions’ industry to the changing conditions of external environment.