Background: This study aimed to describe deaths whose underlying or associated cause was chronic obstructive pulmonary disease (COPD) and analyse trends in COPD mortality from 1979 through 2002 in France. Methods: Data, which came from the centre of epidemiology for medical causes of death, covered individuals aged 45 years or older. Due to implementation of ICD-10 in 2000 for recording causes of death, two separate periods (1979-1999, 2000-2002) were analysed. Results: In 2000-2002, COPD was the underlying cause of 1.4% of deaths (deaths from COPD) and was mentioned on death certificate in 3.0% (deaths with COPD). The other main underlying causes in those cases were cardiovascular diseases (32.0%) and cancers (24.5%). From 1979 through 1999, age-standardised rates of death with COPD remained stable among men (0.01%/year) and increased among women (+1.7%/year). Mean annual rates/100,000 of death with COPD were 84 for men and 19 for women in 2000-2002. Conclusion: In conclusion, multiple-cause analysis improved the estimate of COPD-related mortality. From 1979 through 1999, COPD-related mortality rates stabilised in France among men but increased among women. Implementation of ICD-10 in 2000 introduced substantial discontinuities in mortality trends. (R.A.)