Background: This study is designed to estimate the mortality rate and to assess the relation between other risk factors for mortality and death in adults with diabetes by analysis of death certificates in Yonchon cohort population. Methods: A population-based cross-sectional study was conducted in 1993 in Yonchon county to estimate the prevalence and risk factors of diabetes. This study population consists of respondents(2,463 persons) from Yonchon study and followed for 6 years from 1993 to 1998. Status of death and causes of death were determined from death certificates from National Statistical Office. Results: During the 6 year follow-up, 18 deaths(10%) occurred in the 184 persons with diabetes and 69 deaths(3.3%) occurred in the 2,113 persons without diabetes. After adjustment for multiple variable(age, sex, total cholesterol, systolic blood pressure, smoking and body mass index(BMI)), mortality rate was significantly higher for diabetic adults than non-diabetic adults(RR, 2.03). The proportional hazard analysis for all-cause mortality in the 190 persons with diabetes showed that smoking, high total cholesterol, and high LDL-cholesterol were significantly associated with increased risk for mortality(p value < 0.05), but BMI, HDL-cholesterol, and high systolic blood pressure were not significantly associated with increased risk for mortality. Conclusions: This study was a prospective cohort study that followed 2,463 persons of Yonchon cohort for 6 years and showed that diabetic adults had higher mortality than non-diabetic adults. The strength of the association between risk factors and mortality was less clear because follow-up period was short and study population size was small, therefore further follow-up study are needed(J Kor Diabetes Asso 25:384∼398, 2001).