Four hundred fifty-four death certificates showing measles as the cause of death were analyzed. These represented 35.4% of the recorded deaths due to measles from 1964 through 1971. Respiratory or neurologic complications of measles or both were noted as the primary cause of death on nearly 90% of the certificates reviewed. In younger children, death was most frequently attributed to respiratory problems, while encephalitis and other neurologic sequelae of measles accounted for a larger percentage of deaths in the 10- to 14-year-olds. Nearly 17% of the persons who died had some underlying disease at the time of death, the percentage increasing with age. The majority of this group were physically or mentally retarded, or both.