For several decades, Wilson’s disease (WD) has remained the focus of attention for a wide range of specialists, including hepatologists, general practitioners, neurologists, geneticists, etc. However, despite significant advances in understanding its molecular basis, establishing clear correlations between the genotype and clinical phenotype of the disease remains a key unresolved issue. The study aimed to identify patterns between genetic variants in the ATP7B gene and the WD clinical manifestations using next-generation sequencing. The data from 81 WD patients, who were followed up between 2015 and 2019, were used in the study. Molecular genetic testing of biomaterial (blood) samples was performed by NGS. The analysis of the molecular genetic testing results using targeted NGS revealed 31 pathogenic variants. The following variants were the most frequent: c.3207C>A (p.His1069Gln) — 51.85% alleles, c.3190G>A (p.Glu1064Lys) — 8.64% alleles, and c.3402delC (p.Ala1135fs) — 6.17% alleles. A moderate correlation between genotype and phenotype was established: pathogenic variants (nonsense, frameshift, splicing) in the homo- or compound heterozygous state are associated with severe liver damage, severe degree of cirrhosis, and lower cholinesterase levels. The data obtained emphasize the importance of molecular genetic diagnosis for clarifying the diagnosis of WD and predicting the disease severity.