On the basis of the 1990 Chinese death notice data and 1990 Japanese populations vital statistical materials, the mortality patterns and proportions of individual causes of death in the two countries were compared. In both sexes, the mortality rates were the highest in almost all age groups in Chinese rural areas followed by urban areas and Japan. In Japan and in Chinese urban areas, malignant neoplasms cardiovascular diseases and cerebrovascular diseases were the major causes of death, with these three making up about 60% of the total. In Chinese rural areas, these three conditions were responsible for 43% of all deaths, a considerably lower figure as compared to those in the other two areas, and the mortality rates for infectious diseases and accident/suicide were higher than those in the other two areas. Of the three major adult diseases, cerebrovascular diseases were found to be especially frequent in both Chinese urban and rural areas. On the other hand, ischemic heart disease was found at comparable levels in Japan and China and the rate was lower than in other developed countries. Site-specific mortality rates for malignant neoplasms were characterized by high rates for lung, liver and esophageal cancers in China. The mortality rates for bronchitis in both Chinese urban and rural areas were markedly higher than those in Japan These differences in mortality rates and proportions of individual causes of death between China and Japan are thought to be attributable to the differences in medical services and the level of risk factors for each disease.