This paper is devoted to trends in capital structure choice of private pharmaceutical companies in Russia. The sample of 144 private pharmaceutical companies for the period from 2006 to 2011 is used for testing hypotheses on capital structure determinants. It is revealed that main firm-specific factors affecting the total debt to total assets ratio are firm's size, profitability, assets' structure, and short-term liquidity. The negative impact of the recent economic crisis has been confirmed. It is found that unstable macroeconomic and institutional environment influences the capital structure significantly.