Introduction <p>Many pollutants constantly worsen the ecological situation, thereby causing irreparable harm to the health of the population. Technogenic impact on the biosphere has become one of the significant factors dictating our conditions of existence on Earth.</p> Purpose of the study <p>to conduct a comparative analysis of the frequency of cytogenetic abnormalities, indicators of proliferation disorders and nuclear destruction of vaginal and buccal epithelium of pregnant women 26–33&#xa0;years old living in conditions of radioactive, chemical and combined environmental contamination of the Bryansk region. </p> Methods <p>micronucleus test, staining method by Kvik, fluorescence method, immunocytochemistry method, Shapiro–Wilk test, Mann–Whitney U test.</p> Results <p>the frequency of cytogenetic abnormalities, indicators of proliferation disorders and nuclear destruction in the vaginal epithelium of pregnant women living in areas of radioactive, chemical and combined environmental contamination is 1.3–4.9 times higher, and in the buccal epithelium 1.6–7.8 times higher compared to ecologically safe (control) areas (<i>p</i> &lt; 0.01–0.001). The combined effect of radioactive contamination and chemical pollution resulted in a significantly higher (increase from 12.8% to 81.4% in vaginal epithelium and from 22.6% to 2.3 times in buccal epithelium) frequency of cells with micronuclei, cells with protrusions, binuclear cells, cells with double nuclei, as well as cells with karyopyknosis and karyolysis in pregnant women compared to areas with only one pollution factor.</p> Conclusion <p>The results demonstrate the synergistic effects of radiation contamination and chemical pollution on the cytogenetic status of pregnant women.</p>