BACKGROUND: In 33 educational schools of the Russian Ministry of Defense, approximately 18,000 students are enrolled in programs preparing them for military or other public service functions. These programs are focused on the development of an active personality, innovative thinking, physical training, and the improvement of the body’s functional reserves. AIM: of this study was to compare the primary incidence trends and patterns categorized by the International Classification of Diseases, 10th revision, among students of pre-university educational schools of the Russian Ministry of Defense and general population of Russian adolescents over a 12-year period (2010–2022). METHODS: The analysis included primary disease incidence data submitted with 13K/MED reports. Primary disease codes were matched with classes of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. The incidence rates were calculated per 1000 students (%). The primary disease incidence rates were compared between students and general population of adolescents aged 15–17 years. The long-term average annual rate was determined based on total absolute values over the 12-year period. The annual average rates alongside with arithmetic means and their standard errors (M ± m) were calculated for the analysis of similarities (differences). The trends were assessed by analyzing time series and calculating a second-order polynomial trendline. RESULTS: Among students, the long-term average annual and average annual rates were 2694.3% and 2709.0 ± 77.1%, respectively, in 2010–2022. For Russian adolescents, lower values were observed, i.e. 1361.2% and 1380.0 ± 19.9%, respectively (p < 0.001). We assume that higher rates of primary disease incidence among students were attributed to higher rates of disease detection, more accessible qualified and high-tech medical care, and personalized accountability of all cases, including those of mild or moderate severity, which are associated with home treatment and are not reported by regional healthcare facilities of the Russian Ministry of Health. Primary incidence rates were calculated for main classes of diseases reported in students and Russian adolescents. CONCLUSION: The early detection, prevention, timely treatment and rehabilitation of main classes of diseases can significantly reduce the primary disease incidence among students of pre-university educational schools of the Russian Ministry of Defense and Russian adolescents aged 15–17 years.