Objective The study was conducted to describe the characteristics of death patients in hospitals in China, 2006, and to find its differences with general population. Methods The data were collected from death cause register reporting system, including all death cases in hospitals reported by internet from January 1 to December 31, 2006. Underlying death causes were used to analyze the death cause pattern and its rank. Results According to 50 death cause used by WHO, the top ten death causes were malignant tumors (21.73%), heart disease (17.14%), cerebrovascular disease(14.30%), injury (3.67%), chronic lower respiratory tract disease (2.71%), perinatal disease (2.02%), influenza and pneumonia (1.94%), other tumors (1.87%), diabetes (1.62%), primary hypertension and hypertensive renal disease (1.60%). The proportions of death caused by cerebrovascular disease, cancer and other chronic disease reported from hospitals in 2006 were higher than that of national disease surveillance point（DSP）in 2000, but the proportion of chronic obstructive pulmonary disease reported from hospitals was 2.70%, which was lower than 20% of DSP in 2000. The top five death causes of patients either in hospitals or from the reporting system of Chinese Health Ministry included cancer, cerebrovascular disease, heart disease, respiratory disease, injury and poisoning both in urban and rural areas, but with different ranks. Conclusion The main death causes in hospitals in China were malignant tumors, heart disease and cerebrovascular disease, and there were differences on the death cause among hospital patients and general population.