The Northwestern Federal District is a Russian macro-region that is a unique example of a model region. It accounts for 10 % of the country’s total area and 9.5 % of its population. This article aims to trace the patterns of city distribution across the region, to assess the conditions of differently populated cities and towns, and to identify sustainability trends in their socio-economic development. Population change is a reliable indicator of the competitiveness of a city. As a rule, a growing city performs well economically and has a favourable investment climate and high-paid jobs. The analysis revealed that population change occurred at different rates across the federal district in 2002-2017. A result of uneven socio-economic development, this irregularity became more serious as globalisation and open market advanced. The study links the causes and features of growth-related differences to the administrative status, location, and economic specialisation of northwestern cities. The migration behaviour of the population and the geoeconomic position are shown to be the main indicators of the sustainable development of a city.