The most important disease and the most contributory cause of death were pathologically surveyed among 5106 subjects aged 80 years old and over. Bronchopneumonia, encephalomalacia, myocardial infarction, gastric cancer, generalized arteriosclerosis and myocardial hypertrophy were the most prevalent diseases in order of frequency. With advancing age, bronchopneumonia and cerebral and cardiac arteriosclerotic diseases increased, while cancer decreased. This death pattern of the extreme aged has developed during the last 25 years in Japan, and is very similar to the present situation in some European countries.