The use of death certificates for surveillance of occupational mortality patterns in the U.S. to develop information on potential occupational health problems is discussed. The joint efforts of NIOSH, the National Center for Health Statistics, the Bureau of the Census, the Association for Vital Records and Health Statistics and state health departments have resulted in the selection of a standard system for occupation and industry coding of death certificate, development of programs to ensure consistent use of the codes, and development of a computer software package for proportionate mortality ratio analysis. The use of death certificate occupation and industry entry coding has increased from only six states in 1979 to 31 states and the District of Columbia. Proportionate mortality ratio analyses have used information from death certificates coded for occupation and industry. Limitations in the use of information from death certificates include its questionable accuracy, unsuitability for studying nonfatal occupational diseases, and the long latency period for many occupational disorders. The authors conclude that, in spite of certain deficiencies, surveillance of occupational mortality using coded entries from death certificates represents a simple and inexpensive tool for occupational disease surveillance and epidemiological studies.