Mortality statistics derived from death certificates are the only continuously collected, population-based, disease-related information available in most parts of the world, including the United States. For this reason, every effort must be made to ensure that the most specific, accurate, and complete information regarding cause of death is registered on death certificates. This article discusses identification of the underlying and immediate causes of death, the mechanism and manner of death, and completion of the medical certification section of the death certificate. Examples are given to illustrate the appropriate sequencing of causal information and the selection of the proper underlying cause of death.