The frequency of health groups 1 and 2 was studied in children living in the areas of the Orenburg Region, by taking into account the level and nature of their anthropogenic pollution. The pollution indicators of environmental objects (ambient air, drinking water, soil) were analyzed. A cross-sectional population-based study was conducted in 7000 children aged 1 month to 18 years, who lived in the urban and rural areas. In the urban areas, health group 1 and 2 children were 2.2- and 1.6-foldfewer than that in the rural ones, respectively. Ambient air pollution was found to have a priority impact on the children's health.