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During 2000–2022, a total of 69 of Russia’s 85 administrative regions reported 164,580 hemorrhagic fever with renal syndrome (HFRS) cases, with an annual average rate of 4.9 cases/100,000 population (10⁵ popul.). European Russia reported 162,045 (98.5%) cases in 53/60 regions with 9.7 cases/10⁵ popul. Asian Russia reported 2535 (1.5%) cases in 16/25 regions with 0.6 cases/10⁵ popul. In the same period, Russia reported 668 (0.4%) fatal HFRS cases, and 4030 (2.4%) cases among children under the age of 14 years. Most HFRS cases occurred during autumn and winter. The incidence among rural residents was 6.7 per 10⁵ popul., higher than the urban 4.4 per 10⁵ popul.; however, among HFRS patients, rural and urban residents account for 35% and 65%, respectively. Six hantaviruses, causing HFRS of different clinical severity, were recognized as pathogens: Hantaan (HTNV) and Amur (AMUV) of <i>Orthohantavirus hantanense</i> species, Seoul (SEOV) of <i>Orthohantavirus seoulense</i> species, Puumala (PUUV) of <i>Orthohantavirus puumalaense</i> species, and Kurkino (KURV) and Sochi (SOCV) of <i>Orthohantavirus dobravaense</i> species, with the principal hosts <i>Apodemus agrarius coreae</i>, <i>Apodemus peninsulae</i>, <i>Rattus norvegicus</i>, <i>Myodes glareolus</i>, <i>Apodemus agrarius agrarius</i>, and <i>Sylvaemus ponticus</i>, respectively. It was found that 97.7% of HFRS cases are caused by PUUV, therefore, this virus plays the main role in the HFRS morbidity structure in Russia.