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Health outcomes in Central and Eastern Europe have been generally improving over the last two decades. However, in Czechia, similar to other countries, the outcomes vary significantly across the regional dimension. In 2016, life expectancy at birth ranged from between 75.5 to 80 years – across 77 districts. ;is article empirically analyses the determinants of these differences using a wide range of explanatory variables that are available on a district level. Applying factor analysis, our findings indicate that the socio-economic situation within a district is the main driver – explaining a difference of up to four years in life expectancy at birth. Further, controlling for gender specific variables, the results suggest that for men alcohol consumption significantly reduces life expectancy. Both factors capturing the socio-economic situation and alcohol consumption exceed the impact of health care accessibility or environmental causes on life expectancy. ;e results remain robust when using more disaggregated information on 206 administrative districts – per geographic scale. key words geography of health – regional inequalities – life expectancy – factor analysis – Czechia bělohradský, a., glocker, d. (2019): Regional health inequalities explained: empirical evidence from Czechia. Geografie, 124, 4, 365–383. Received October 2018, accepted September 2019. © Česká geografická společnost, z. s., 2019 366 geografie 124/4 (2019) / a. bělohradský, d. glocker