Oksana Akinshina was born in Leningrad, Russian SFSR, Soviet Union (now Saint Petersburg, Russia), where she currently lives. Her father was a car mechanic and her mother an accountant. She has a younger sister. At the time she landed the role in Lilya 4-ever (2002), Akishnina only spoke Russian, and communicated with director Lukas Moodysson with the help of Alexandra Dahlström as her interpreter.
Starting acting at age 12, Akinshina was discovered by Sergei Bodrov, Jr., and she made her screen début in the Russian crime film Sisters (2001), Bodrov's own directorial début.[citation needed]
Her second film, Lilya 4-Ever (2001), earned her a 2002 European Film Award nomination for Best Actress. She lost, however, to the eight actresses of the film 8 Women (2002), directed by François Ozon. For her role in Lilya 4-Ever, she also received the award for Best Actress in Leading Role from the Guldbagge Awards, Sweden's national film awards.[citation needed]

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