Objective To investigate major causes of chronic diseases and death from 2004 to 2006 in Gang Za district of Nan Tong city. Methods According to ICD-10, the data of diseases were coded and classified. Mortalities were accounted. Results The crude mortality of the whole crowd was for 754.26 / 100 000, and standardized mortality was for 419.47 / 100 000. The crude mortalities of chronic diseases (malignant tumor, cerebrovascular disease, respiratory system, cardiac disease and endocrine system disease) were for 208.97 / 100 000, 151.79 / 100 000, 114.17 / 100 000, 101.38 / 100 000, 16.55 / 100 000, and standardized mortalities were for 77.73/ 100 000, 56.14 / 100 000, 50.28 / 100 000, 9.19 / 100 000. The percent of death was 78.60%. The standardized mortalities of malignant tumor, cerebrovascular disease and endocrine system disease were in the up trend. Conclusions It is clear that malignant tumor, cerebrovascular disease,respiratory system, cardiac disease were the most important causes of death. Health education and effective prevention should be strengthened in order to reduce the mortality of chronic diseases.