Abstract: Objective To understand the underreporting of death in disease surveillance system in Hubei province from 2009 to 2011. Methods Household survey about family member death was conducted at the selected communities/townships covered by the surveillance system in Hubei from January 1, 2009 to December 31, 2012,the results were compared with the data reported by the disease surveillance system. Results The overall underreporting rate of death at 11 communities/townships sampled was 8.59%. No gender, cause and year specific differences in underreporting of death were observed, but the area, age and site specific differences in underreporting of death were statistical significant. The underreporting rate was higher in rural area than in urban area and in infants/young children than in other age groups. The underreporting of injury death occurred at non specific place was higher than that in hospitals and homes. Conclusion The death cause surveillance data was with completeness in Hubei, but it is necessary to take measures to reduce the underreporting of death in rural area and in infants/young children and the underreporting of injury death.