Abstract: Objective To evaluate the quality of death cause reports in medical institutions in Guangdong Province and provide the basis for improving the data quality and utilization. Methods Data of death cause in Guangdong Province from 2005 to 2012 were collected from the “ information system for death cause register and report ” of “ China information system for disease control and prevention ” Using the method of descriptive epidemiology, the quality of death cause repots was analyzed and evaluated by the indicators of county reporting rate, unit reporting rate, timely reporting rate, timely checking rate, coding error rate of death cause, proportion of reporting deaths of medical institutions to deaths among total population, and proportion of reporting deaths of medical institutions at and above county level to total deaths in these institutes. Results From 2005 to 2012, the reporting death rate of medical institutions in Guang dong were increased from 38.65/100 000 to 164.55/ 100 000, the county reporting rate increased from 88.40% to 100.00%, the unit reporting rate of medical institutions above county level increased from 39.40% to 69.30%, the unit reporting rate of medical institutions at town ship and community levels increased from 14.24% to 34.70%, and timely reporting rate increased from 55.25% in 2007 to 85.19% in 2012. The checking rates were kept higher level (94.94% - 99.96%). The timely checking rates increased from 79.90% in 2006 to 97.56% in 2012 in institutions of disease control and prevention. The coding error rate declined to 8.59% in 2012 from 36.62% in 2005. The proportion of reporting deaths of medical institutions to deaths among total population was 27.33% and the proportion of reporting deaths of medical institutions at and above county level to total deaths in these institutes was 49.46%. Among all cities, the top three unit reporting rates of medical institutions were 100.00% in Zhuhai, 90.91% in Dongguan, and 83.80% in Guangzhou, but lower than 60% in six cities; the unit reporting rates at the town medical institutions was ranked by Jiangmen (89.66%), Guangzhou (78.73%), and Shenzhen (73.17%), but lower than 20% in another 11 cities. The proportion of reporting deaths of medical institutions to deaths among total population was ranked by Zhuhai (95.23%), Jiangmen (91.09%), Guangzhou (75.60%), and Dongguan (65.09%) in descending order, but lower than 40% in other cities. Conclusion The quality of death cause reports in medical institutions in Guangdong was improved greatly from 2005 to 2012. But the levels of reporting quality were unbalanced in all cities. The quality of death cause reports were better in Guangzhou, Zhuhai, Jiangmen and Dongguan City than the other 17 cities. It is essential to promote the strategy for death cause reporting of the population, sustain training for grassroots health workers, and evaluate the reporting quality at regular interval.