Dramatic fluctuations have occurred in population health in Russia since the collapse of the Soviet Union. Although many factors have been examined in connection with this, there has been little focus on the role of the family, despite evidence from Western studies linking family functioning to individual health. Using data from 1,190 respondents collected during the Moscow Health Survey 2004 we examined the association between family relations and health outcomes. Poorer family functioning was strongly associated with worse self-rated physical health and mental health. Our results suggest that the proximal social environment of the family is important for understanding health outcomes in contemporary Russia.