Background - For many years, deaths occurring before age 65 have been routinely used in France and other countries to monitor the health status of the population and inform public policy in this area. The objective of this article is to assess the potential utility of another mortality indicator that accounts for the impact of premature deaths: years of life lost (YLL). Methods - Mortality data cover the years 2000 to 2002 in metropolitan France. Premature mortality is defined by death rates before the age of 65. For the calculation of PYLL, life expectancies by sex and age used as references are derived from the 2001–2003 French mortality table. To enable the study of the geographic distribution of the indicators defined above, standardized ratios are calculated by department, using mainland France as the reference population. Results - Regardless of gender and indicator considered, the ranking of causes highlights three major groups of conditions that stand out significantly from the others: circulatory system diseases, tumors, and external causes. The hierarchy of the various causes obtained varies significantly depending on the indicator used. The spatial representation of the standardized ratios for AEVP and deaths before age 65 reveals the same North/South differentiation in France. Conclusion - The concept of premature mortality is difficult to define, and discussions persist regarding the age cutoff to use for quantifying it. The choice of indicator depends heavily on the intended use. The analysis of deaths before age 65, currently used to describe premature mortality in France, allows for the quantification of its frequency. The use of an indicator such as AEVP allows for the quantification of the impact of premature mortality by placing greater weight on deaths occurring at younger ages. AEVP therefore appears to be a particularly suitable indicator for public health decision-making, depending on the choices and values one wishes to prioritize. (R.A.)