Ear and mastoid diseases are not only a medical and social problem, but also an economic one due to their high prevalence, development of severe complications and decreased quality of life. The aim of the study is to investigate the gender and age characteristics of the economic burden of ear and mastoid diseases in the Voronezh region for 2018—2023. Material and methods. A retrospective analytical descriptive study was conducted. The economic burden of ear and mastoid diseases among the adult population of the Voronezh region was studied for the period 2018—2023. The source of information was data from accounts from the territorial fund of compulsory medical insurance (TFOMS) of the Voronezh region. Results. The results of this study showed the gender and age characteristics of direct economic costs for the treatment of ear and mastoid diseases among the adult population of the Voronezh Region for 2018—2023, which in total over six years amounted to 555,272.5 thousand rubles. The age group of 60—69 years is the most resource-intensive for medical organizations from an economic point of view, while this age group of patients ranks first in the structure of outpatient and polyclinic medical care and in the top three in the structure of inpatient medical care. The costs of providing medical care for diseases of the ear and mastoid process among women significantly exceed those among men. The study shows that 95.6% of all costs for diseases of the ear and mastoid process fall on seven groups of diseases, of which four groups are acute and chronic inflammatory diseases. Of the other three groups, the most significant is conductive and sensorineural hearing loss, due to the fact that, according to the literature, this disease is the most common cause of hearing loss among the older generation. Conclusions. The economic burden of ear and mastoid diseases in the Voronezh region for the period 2018—2023 amounted to 555272.5 thousand rubles. Gender and age characteristics of the economic burden of ear and mastoid diseases were identified, which showed that women predominate over men in the structure of expenses, and the age group of patients aged 60—69 years. 95.6% of all expenses for diseases of the ear and mastoid process are accounted for by seven groups of diseases, which include non-suppurative otitis media, purulent and unspecified otitis media, otitis externa, other diseases of the outer ear, conductive and sensorineural hearing loss, inflammation and obstruction of the auditory tube and vestibular dysfunction. The conducted assessment of the costs of providing medical care to patients with diseases of the ear and mastoid process will contribute to more effective economic planning in the public health system.