Objective: This study attempts to provide fundamental information to help with the development of health policy and health services by looking at the trends of the gender-specific mortality rates in Korea and Japan. Design: The death statistics of Korea and Japan over the 21-year period from 1983 to 2003 are analyzed. Setting: We used the death statistics and estimated population figures published by the Korean National Statistical Office, and the vital statistics published by Ministry of Health and Welfare of Japan. Method: Mortality data are standardized x100,000 to 2001/2003. Specific mortality rates from 12 selected causes are considered: tuberculosis, malignant neoplasms, diabetes mellitus, hypertensive diseases, heart diseases, cerebrovascular disease, pneumonia, diseases of the liver, renal failure, transport accidents, falls and suicide. Results: In Korea, the mortality rates from malignant neoplasms, diabetes mellitus, renal failure, falls and suicide have increased. The proportion of the mortality rates from chronic diseases is higher than from acute diseases. In Japan, the mortality rate from pneumonia increased more than that from diabetes mellitus. The gap in mortality rates between males and females in Korea is greater, especially in terms of malignant neoplasms, diseases of the liver, transport accidents and suicide. Conclusion: The mortality rates from these diseases are higher in males than in females. For the recent health promotion policies in Korea such as "Health Plan 2010", a more intensive and objective management drawing on the findings of this study concerning gender-specific mortality rates should be implemented.