The article provides the first detailed English-language analysis of the forensic medical system in Russia, exploring its historical development and institutional design. Forensic medical experts in Russia play a crucial role in criminal and civil proceedings. With historical roots in the Russian Empire and the Soviet Union, the current system is built on an integrated and police-based model. Russian forensic medicine ensures professional specialization and standardization, but it faces challenges such as underfunding and excessive workloads. The paper highlights a funding mismatch: regional healthcare authorities are responsible for financing forensic medical services even though the primary beneficiaries are federal law enforcement and the courts. This produces systemic organizational gaps-including resource shortages, outdated infrastructure, and overworked personnel-that affect the quality and efficiency of forensic examinations. By addressing institutional path dependence and the coupling of forensic medicine with judicial and law enforcement systems, the study offers valuable insights for comparative research on forensic practices in post-Soviet countries.