Diseases of the musculoskeletal system (MSMS) are highly common among the population, causing high rates of temporary and permanent disability in those affected. The problem is also determined by the wide age range of the sick — from young to elderly, which dictates the need to assess the prevalence and regional characteristics of musculoskeletal pathology among the population, including those of working age. The purpose of the study is to investigate the regional features of the primary incidence of the adult population of working age in the Volga Federal District (VFD) with diseases of class ICD-10 XIII (M00‑M99) «Diseases of the musculoskeletal system and connective tissue» during the COVID-19 pandemic in 2020–2021. Methods of descriptive and applied statistics were used in the research process. Statistical collections with information on the incidence of BCM in the adult population and the population over working age were studied. For a comparative assessment, we used the construction of a 95 % confidence interval for the average incidence value for the period 2012–2019. method of generating repeated samples (bootstrap). Growth rate ( %) of the incidence rate in 2020–2021. calculated to average values for 2012–2019. Using the non-parametric Wilcoxon test, the differences between the values of all studied indicators and primary incidence (PI) for 2020–2021 (p) were assessed. The variability of indicators was assessed using coefficients of variation (Cv). For statistical processing of the generated database, the Microsoft Excel program and the Wolfram Research Mathematica v.11.3 system were used. During the studied period, the adult population living in the Volga Federal District was characterized by a decrease in the incidence of diseases of the musculoskeletal system. Significant fluctuations in primary incidence were revealed. In 2020–2021 For most of the studied indicators, there was an increase in Cv of primary morbidity, differences in morbidity levels for individual nosological forms of diseases of the musculoskeletal system in the regions of the district. During the pandemic of the new coronavirus infection in the Volga Federal District, multidirectional changes in the levels of primary incidence of diseases of the musculoskeletal system were observed, which was most likely due to the limitation of the provision of specialized medical care in certain regions.