The clinical notes of the 146 patients who died during a five year period in the psychiatric ward at the Muhimbili Hospital were studied and analysed to identify gender, age, duration of hospital stay, psychiatric diagnosis and primary cause of mortality. There were 99 (67.8%) males and 47 (32.2%) females. The mean age, which could be established in only 105 (71.9%) instances, was 31.1 years. The average hospital stay was 21.6 days. The main psychiatric morbidity consisted of functional psychoses (52.7%), organic psychoses (37.6%), epilepsy (6.2%) and puerperal psychosis (2.1%). Mortality was primarily attributed to infectious diseases in at least half of the cases. Pyrexia of unknown origin was associated with death in 11.0% of cases and the cause of death could not be established in 17.1%. Clinical notes need to be improved and greater efforts made to diagnose and treat concomitant physical illnesses effectively.