The Rudny Altai metallogenic province, which is concordant to the structures of the eponymous terrane and located in the Central Asian orogenic belt (CAOB), is one of the largest volcanic massive sulfide (VMS) provinces in the world. Lead isotopic composition of galena (61 samples in total) was measured for the first time with high accuracy (±0.02%, SD) for 20 sulfide base metal deposits representing the dominant Kuroko type in the Rudny Altai. They are enclosed in the Early–Middle Devonian volcano-sedimentary sequence in association with volcanic rocks of the bimodal basalt-rhyolite series. We studied the large and superlarge deposits of this type: Ridder-Sokol’noe, Tishinskoe, Novo-Leninogorskoe, Zyryanovskoe, Zmeinogorskoe, and Korbalikha. In the province, the isotope ratios 206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb vary within narrow limits. At average values of 206Pb/204Pb = 17.820, 207Pb/204Pb = 15.517 and 208Pb/204Pb = 37.669, the root mean square variations (variation coefficient, %) are 0.22, 0.038 and 0.063% respectively. Even more homogeneous composition is observed within ore districts of the province (0.054, 0.012 and 0.020%) and especially within deposits (0.025, 0.010 and 0.013%), where the scale of variations of lead isotope ratios reaches their measurement error (±0.02%). The lead isotopic composition in the province shows no isotopic “signatures” of juvenile (asthenospheric) origin. The evolutionary characteristics of the lead source (its depletion in uranium, the old model Pb-Pb age, and moderate values of the µ2 parameter) together with the persistent isotopic composition allow us to regard the lithospheric mantle consisting of metasomatized and recycled rocks as its source. This source was of regional significance, chemically (U-Th-Pb) and isotopically (Pb-Pb) homogeneous, and common for all deposits. Among other CAOB terranes, including the Chinese Altai, the 206Pb, 207Pb and 208Pb isotopes in the ore lead of the Rudny Altai terrane have the least radiogenic composition. The previously noted (Chiaradia et al., 2006) systematic decrease of radiogenic isotope content in the lead of ores and rocks of the CAOB terranes from the southwest to the northeast correlates with a decrease in the lower crustal contribution in the same direction in their composition, where fragments and blocks of Precambrian crust are also involved. The peculiarity of the Pb isotopic composition of the Rudny Altai terrane is largely determined by the absence of Precambrian crustal blocks in its composition.