Objective — to investigate the distribution of the average absolute fracture risk in relation to age, sex and climatic and geographic area and to characterize its associations with concomitant chronic non-communicable diseases (CNCDs). Subject and methods. The survey was conducted in eight cities of the Russian Federation (RF). A systematic stratified multistage random sample was formed on the territorial principle within each region. The cross-sectional survey enrolled a total of 9143 participants (6324 women and 2819 men) aged 40—69 years who had been examined in 2012—2014; whose mean age was 53.29±0.02 years. This survey used the standard ESSE-RF study modular questionnaire that included the questions containing information on risk factors for osteoporosis and fractures, which enter the fracture risk assessment (FRAX) calculator. The absolute fracture risk in the next 10 years was calculated using the Russian FRAX model, without taking into account bone mineral density by batch processing. The therapeutic intervention threshold (TIT) proposed by the Russian Osteoporosis Association in 2012 was used to identify individuals at high risk for fractures. The investigators studied a relationship of the absolute fracture risk to the following CNCDs: cardiovascular diseases, diabetes mellitus, chronic bronchitis, gastric ulcer, spondyloarthritis, and anxiety/depression. The obtained data were analyzed using the statistical analysis system. Results. In the total sample, the average 10-year probability of major osteoporotic fractures (MF) and femoral fractures (FF) was 7.8 and 0.7%, respectively; it was significantly higher in women than in men (p=0.0001). There was a gradual increase in the 10-year probability of MF with age from 5.9% in the group 40—44 years to 10.2% in the group 65—69 years (in both women and men). At the age of 70 years, the risk of MF increased 2-fold in women, and 1.2-fold in men; and that of FF did 5.5- and 4.5-fold, respectively. The absolute risk of MF and FF significantly varied with the geography of a city and was higher at the northern point (in Vologda) than at the southern point (in Vladikavkaz) (8.15% vs 7.72%; p<0.05), but no north-south latitude gradient was observed. There was no significant difference in the risk of MF and FF between the extreme western and eastern cities. In the total sample, the proportion of individuals at high risk for MF was 7%. Previous osteoporotic fracture were diagnosed in 15.2% of the participants, and among them, there were 30.6% of the respondents in the high-risk area and 69.4% in the low-risk one, as evidenced by the schedule determining TIT in the RF. The ten-year probability of MF and FF increased with age regardless of gender and prevailed in the female population of all cities. The vast majority of participants were diagnosed with at least one disease. The accumulation of diseases and multiple abnormalities at high risk of fractures was observed. After adjustment for age and city of survey, the chance of detecting four or more diseases at high risk of fractures was increased 1.8- and 2-fold in men and women, respectively. Conclusion. The epidemiological survey showed differences in the mean values of the 10-year probability of fractures in different regions of the RF. The ten-year probability of MF and FF increased with age regardless of gender and prevailed in the female population of all cities. TIT was confirmed to be of low prognostic value. The prevalence of CNCDs varied in the women from the cities of the RF; and the men exhibited no significant inter-regional disparities. The number of comorbidities increased with age; however, after adjustment for age and city of survey, comorbidities were associated with the high risk of fractures.