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Previous studies evidenced the critical role of the mismatch repair system in DNA damage recognition, cell cycle arrest, apoptosis and DNA repair. MLH1 and MSH2 genes belong to repairing complexes of mismatch repair system. The side effects of ionizing radiation on the human health were proved, but researches on the inhabitants of high background radiation areas, with extra-ordinary radiation exposure, showed that the prevalence of cancer or radiation-related diseases is not significantly higher than normal background areas. The city of Ramsar, in northern Iran, has the highest level of natural background radiation in the world and in this study, we aimed to evaluate the expression of MLH1 and MSH2 genes among the inhabitants of high background radiation areas of Ramsar compared to normal background radiation areas. In the present study, 60 blood sample from high and normal background inhabitants were collected and we MLH1, and MSH2 genes expressions in residents of high background radiation area compared with normal background radiation area were evaluated by Quantitative Real-Time PCR. Our results showed a significant upregulation of MLH1 in residents of high background radiation area. Also, there is a significant association between MLH1 and MSH2 gene expression in both sexes. Also, the increased expression of MLH1 in HBRA is notable. There is an increased expression of MLH1 in age above 50 and a decreased expression of MSH2 in ages under 50 years (P < 0.0001). These findings are suggesting the triggering of Mismatch Repair system in response to high-level of natural background radiation., (Copyright © 2019 Elsevier Ltd. All rights reserved.)