This paper examines and quantifies the impact of weather shocks on all-cause, cardiovascular-, and respiratory-cause mortality for different age groups in Russia. Using a regional panel data analysis from 1989 to 2014, we find that both hot and cold days cause an increase in all-cause and cause-specific mortality. On the other hand, days with extremely cold temperature (below − 30 °C) may have an opposite impact and reduce mortality. Overall, our findings suggest that the economic costs of all-cause mortality due to one day with hot and cold temperatures correspond to 10.25 million USD and 7.91 million USD or 0.28% and 0.22% of daily GDP in Russia, respectively. The results also suggest that regions frequently experiencing hot and cold temperatures have adapted to these temperatures.