OBJECTIVES: This report presents final 2004 data on U.S. deaths; death rates; life expectancy; infant and maternal mortality; and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, state of residence, and cause of death. Previous reports presented preliminary mortality data for 2004 and summarized key findings in the final data for 2004. METHODS: This report presents descriptive tabulations of information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the state registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases, Tenth Revision (ICD-10). RESULTS: In 2004, a total of 2,397,615 deaths were reported in the United States. The age-adjusted death rate was 800.8 deaths per 100,000 standard population, representing a decrease of 3.8 percent from the 2003 rate and a record low historical figure. Life expectancy at birth rose by 0.4 year to a record high of 77.8 years. Age-specific death rates decreased for all age groups. (The decrease for children aged 5-14 years was not statistically significant.) The 15 leading causes of death in 2004 remained the same as in 2003. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over one-half of all deaths. In 2004, Alzheimer's disease surpassed and swapped positions with Influenza, relative to their previous placements in 2003. The infant mortality rate in 2004 was 6.79 per 1000 births. CONCLUSIONS: Generally, mortality patterns in 2004 were consistent with long-term trends. Life expectancy in 2004 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. Although not statistically significant, the decrease in the infant mortality rate is typical of recent trends; except for 2002, the infant mortality rate has either decreased or remained level each successive year from 1958 to 2004.