Abstract <p>The problem of environmental pollution remains one of the most pressing issues of our time, affecting all countries and regions of the world. The purpose of the study is to assess the cytomorphological state of the buccal epithelium of the cheeks and rhinocytogram in individuals living in the city of Stepnogorsk under conditions of high technogenic stress. Non-invasive smears were collected from the nasal mucosa and buccal cheeks of 20 individuals from Stepnogorsk and 20 controls from a relatively clean area. Cytomorphological analysis revealed significant structural and functional alterations in the exposed group. In buccal epithelial cells, the frequency of apoptotic corpuscles increased from 0.0 ± 0.0% in controls to 5.9 ± 0.1% in the exposed group; karyorrhexis from 15.4 ± 1.4 to 33.2 ± 2.2%; and binucleated cells from 0.5 ± 0.1 to 3.1 ± 0.1%. Normal epithelial cells decreased significantly from 76.2 ± 4.8 to 28.8 ± 2.5%, and vacuolar dystrophy increased to 10.6 ± 1.0%. Microbial contamination with staphylococci and streptococci rose from 12.0 ± 2.8 to 35.2 ± 3.6%, suggesting a weakened mucosal barrier. These changes indicate cytotoxic, genotoxic, and inflammatory responses likely linked to chronic environmental exposure. The nasal and buccal mucosae, as primary contact surfaces, serve as sensitive indicators of environmental health hazards. Our findings emphasize the importance of regular biomonitoring using cytological techniques in high-risk populations. Such assessments can aid in the early detection of adverse health effects and guide preventive and environmental remediation strategies.</p>