Abstract: Objective To evaluate the quality of death case reporting in medical institutions at county level or above in Hangzhou. Methods The evaluation was conducted on the reporting coverage rate, timely reporting rate and reported death proportion in total population of medical institutions, and the verifying rate, the timely verifying rate and the proportion of non accurate underlying death causes code of disease control and prevention centers at county (district) level. Results The reporting coverage rate was 100%, the timely reporting rate was 98.81%, and the proportion of reported deaths in total population was 21.43%. The verifying rate was 100%, and the timely verifying rate was 99.30%, and the proportion of non accurate underlying death causes code was 2.05%. Conclusion The quality of death case reporting in medical institutions at county level or above was good. It is necessary to strengthen the training on the coding of underlying death causes.