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Kirilenko was born in the Soviet city of Izhevsk, Russia. When he was ten, he began playing organized basketball. In 1997, Kirilenko became the youngest player ever to compete in the Russian Super League. After spending two seasons with Spartak Saint Petersburg, he joined CSKA Moscow in 1998. In his first season, he helped his new team win the Russian Super League championship. He was also selected to participate in the Russian All-Star game, helping the West beat the East 138–107 and winning the slam dunk contest.
In June 30, 1999, at age 18 years, 132 days, Kirilenko was the youngest foreign player at the time to be drafted in the National Basketball Association, when the Utah Jazz selected him with the 24th pick. Kirilenko was also the first Russian picked in the first round of an NBA Draft. However, he remained with CSKA Moscow for the next two seasons. In the 1999–2000 season, he helped his team win the championship of the North European Basketball League and its second Russian Super League championship in a row. On April 23, 2000, he participated in his second Russian All-Star game, helping the West beat the East 122–111. Despite being the odds-on favorite to win the slam dunk contest, he finished second to Harold Deane of Lokomotiv Mineralnye Vody.
Kirilenko participated in the 2000 Summer Olympics as a member of the Russian national basketball team, which finished 8th in the tournament. On February 8, 2001, in his third season with CSKA Moscow, Kirilenko became the second player ever in the history of the FIBA SuproLeague to record a triple-double with 13 points, 11 rebounds, and 10 steals against Lietuvos Rytas. He showed off his all-around skills in the SuproLeague, finishing in the top ten in 7 out of 8 statistical categories.
Kirilenko joined the Utah Jazz in 2001. He was named to the first team on the NBA All-Rookie Team. He emerged as one of the top young players in the NBA, and one of the league's top weak-side defenders. He was selected to play as a reserve in the 2004 NBA All-Star Game in Los Angeles. In the 2003–04 NBA season, he ranked third in the league in blocked shots per game and fourth in the league in steals per game, becoming just the second player in NBA history to rank in the top five in both categories (David Robinson ranked first in blocked shots per game and fifth in steals per game in the 1991–92 NBA season). During the NBA off-season, Kirilenko played for the Russian national basketball team.
Kirilenko became the leader of the Jazz in 2003 after John Stockton retired and Karl Malone left Utah to join the Los Angeles Lakers. He played and started in 78 of the Utah's 82 games and led them to a 42–40 record. Utah missed the playoffs by one game behind the Denver Nuggets. He finished fifth in Defensive Player of the Year voting and fourth in Most Improved Player voting and was named to the second team on the All-NBA Defensive Team. Kirilenko led the Jazz in many statistical categories: