Abstract: The object of this research is the social sphere of the Russian Empire in the late XIX century as a result of implementation of Zemstvo Reform in 1864. The subject of this research is the peculiarities of changes in organization of healthcare system in Kaluga Governorate during the 1864-1871, occurred due to Zemstvo Reform. Based on the studied materials, the author provides data on the situation in medicine prior to the reform of 1864 in the region; as well as analyzes particular examples of such transformations related to implementation of new regulations of Zemstvo Reform in the area of healthcare. The scientific novelty consists in examination of the previously unused archival documents of the State Archive of Kaluga Oblast, which allowed the new factual material on conducting Zemstvo Reform in Kaluga Governorate during the viewing 1864-181 and its implementation in healthcare. It is concluded that even though the Kaluga Governorate provided significant aid in country healthcare and solutions to the number of issues in medicine, they did not have freedom in decision-making and spending for this paramount component of life of the county.