Background:The Aral crisis consider as one of the largest ecological catastrophes on the planet. TheKazakhstan part of the Aral Sea regiondeclared an environmental disaster zone. The constantly changing unfavorable environmental situation contributed to higher number of thyroid pathology and initiates the study of this problem in women of reproductive age in the AralSea area.Aims:To study thyroid function in women of reproductive age living in ecologically unfavorable territories of Kazakhstan part of the Aral Sea region.Materials and methods: The survey was conducted within scientific and technical program: “Integrated approaches in managing the health status of the population of the Aral Sea region” 2014–2016 years, performed by Ministry of Health and Social Development of the Republic of Kazakhstan. The study was cross-sectional, observational, uncontrolled and multicenter.Study included the representative sample of 2205 women of reproductive age from 18 to 49 years old living in the Aral Sea region.The levels ofTSH,FT4and AntiTPOweredetermined by the laboratory of collective use of KSMU on the Evolis Robotized System using“Tiroid-ELISA-TTG,0.23-3.4µIU/ml”, “Thyroid–ELISAfreeT4,10-23.2pmol/l”,“Tiroid ELISA – atTPO,<30EDU/ml”testsystems.Results:A huge number of women from environmental disadvantaged areas of the Kazakhstan part of the Aral Sea region have TSH values exceeding reference of 3.4 μI/ml.The frequency of SH was 0.2%;0.9%,0.2% in the different study areas at TTG values≥10.0 μIU/ml and freeT4 from 10to23.2 pmol/l. The frequency of MH was 2.4%;2.7%,2.5% in the studied areas at TSH values ≥10.0μIU/ml and FreeT4<10.0 pmol/l, Thus, the data obtained on the prevalence of reduced thyroid function in women living in the studied areas of the Aral Sea ecological disaster can be considered as comparative. About3%of women of reproductive age neededon replacement therapy for hypothyroidism. Thelargest number of women with elevated AT-TPO identified in the zone of the ecological crisis. Almost same number of women with hypothyroidism was revealed among AT-TPO hosts in all studied zones.Conclusions: Women of reproductive age living in ecologically unfavorable territories havea high, comparable frequency of manifest hypothyroidism in the three studied zones of the Kazakhstan part of the Aral Sea region of the Republic of Kazakhstan.