In common with other areas throughout the Russian Federation, western Siberia faces formidable environmental pollution, a problem that in part is the legacy of the highly centralized Soviet era when meeting production quotas was the raison d'être for many managers of economic enterprises. In this region, over the last thirty years the near singular focus on short term oil production has led to severe contamination of the area's surface and groundwater supplies, threatening both human and ecological health. At the same time, revenues from continued oil extraction may provide the means to address some of the environmental problems. In light of the struggling economy and potential political instability, however, it is particularly critical that authorities prioritize environmental investments, as well as cultivate public support for such investments. This paper reports on a recent investigation of this problem by a team of American and Russian scientists, under the sponsorship of the U.S. National Research Council, U.S. National Academy of Sciences, and the Russian Academy of Sciences. The chief recommendation from that investigation is that the region develop an environmental program based on human health risk assessment and management.