Abstract: Objective To evaluate the completeness of death cause reporting through the disease surveillance system in Guangdong province. Methods Capture-recapture method was used in the underreporting survey. The survey townships (community) were selected by cluster sampling in the areas covered by the disease surveillance system in Guangdong. The residents' basic information from 2009-2011, including death data, were collected. The death data collected were compared with the death data reported through the surveillance system and underreporting rate was calculated. Results The underreporting rate of death cause was 14.44%, ranging from 2.91% to 30.38%, during this period. So the adjusted population based mortality was 6.58‰ in Guangdong during 2009-2011 and the mortality in surveillance counties ranged from 3.84‰ to 8.17‰. The completeness of death cause reporting through the disease surveillance system reached 85.11% in Guangdong during 2009-2011, but the completeness could reach 99.15% by adding the underreporting deaths. The rate of death with unknown cause in this study was higher than that in routine reporting. Conclusion The completeness of dearth cause reporting in Guangdong met the state requirements basically. The improvement could be made by conducting underreporting survey on the basis of routine surveillance.