The article examines the problems of sustainable development of the regional economy from the position of the reproductive approach. The expediency of using the reproductive approach as a methodological tool for studying the sustainability and efficiency of economic systems, both at the level of the region and the country as a whole, is noted. Sustainable development of the economic system involves the consideration of reproduction processes from the social, economic and environmental points of view, which makes it possible to assess the sustainability of the processes of production, distribution, exchange and consumption. A system of indicators for assessing the economic, social and environmental sustainability of the development of the region is proposed, based on the sustainability of reproduction processes.