Background. Second cancer s (SC) developing in Hodgkin Lymphoma (HL) patients after treatment significantly affect survival. The studies defining relative risc (RR) of SC in the cohort s of HL patients treated with similar radiotherapy (RT) target volumes and total tumor doses (TTD) are rare. Purpose. The aim was to evaluate RR of SC in HL patients treated with RT alone or chemoradiotherapy (CRT) when irradiation was limited to the lymphatic areas above diaphragm and the spleen. Methods. The study included 1789 initial HL pts , stages I, II, IV (supradiaphragmatic, age 13-69 (87% under 40). Women 1177 (66%), men 612 (34%). The treatment period was between 1968 and 1998. Patients were given either RT alone limited to the lymphatic areas above diaphragm and the spleen, TTD 40 Gy (363 pts, 20.3%) or 6 cycles of chemotherapy COPP + similar RT (1426 pts, 79.7%). The incidence of SC was compared with the data from Cancer Register of Russian Federation. Results. Follow-up was 6 mnths - 36 years (median 18 years). The overall follow-up for the cohort was 18949 patients/years (men 5917, women 13032). SC developed in 80 (4.5%) patients: after RT in 27 (7.4%) of 363 pts, after CRT in 53 (3.7%) of 1426 patients. One tumor occurred in 74 pts, two tumors , two tumors successively in 5 patients and three tumors in 1 patient. The total number of tumors was 87, including 85 (97.7%) solid tumors, 2(2.3%) hemoblastoses. The time of SC occurrence was 1-31 years (median 18). SC RR: overall for the cohort - 2.85 (95% confidence interval (95% CI) 1.85-2.98); in women - 3.02 (95% CI 1.9-3.12); in men - 2.46 (95% CI 1.23-2.91). After RT alone: in women - 3.22 (95% CI 2.11-4.75); in men - 2.51 (95% CI 0.9-4.63). After CRT: in women - 2.9 (95% CI 1.48-3.02); in men - 2.4 (95% CI 1.04-2.96). The prevailing tumors were mammal, thyroid, gastric. The RR of mammal cancer was 4.01 (95% CI 2.46-5.98); gastric cancer: in women - 7.95 (95% CI 3.2-14.4), in men - 4.03 (95% CI 1.0-9.0); thyroid cancer: in women - 7.8 (95% CI 3.47-13.9), in men - beyond 95% CI. 19 (21.8%) of 87 tumors occurred within irradiation fields. Conclusions. In our study the RR of SC in HL patients was 2.85, which is lower than reported by other authors. This probably could be explained by the fact that the study included HL patients in whom irradiation was limited to supradiaphragmatic areas and spleen.