Objective To analyze the cause of death and distribution rule of emergency death in a tertiary hospital in Guangzhou in the past five years, in order to further improve the emergency treatment level of the hospital, and formulate preventive measures and provide reference basis.Methods A retrospective analysis of 1 588 deaths was conducted in the emergency department from 2014 to 2018. The International Classification of Diseases (ICD-10) was used to encode the cause of death, and descriptive statistics and analytical methods were used to analyze the epidemiological characteristics of the deaths in the Emergency Department of the hospital.Results Among the 1 588 emergency deaths, males were more than females (male to female ratio 1.42 ∶1), and the maximum number of deaths was in the group of 80-89 years old(34.13%).Conclusion Among the root causes of death, circulatory disease (I00-I99)ranked the first  (39.86%), the second was tumor (C00-D48), accounting for 22.10%, and the third was respiratory diseases (J00-J99), accounting for 21.47%. It is suggested to conduct regular physical examination, pay attention to the elderly and male groups, conduct early screening for elderly people and cancer patients, improve community health management, raise residents′ health awareness, advocate healthy lifestyle, improve the firstaid treatment system, and reduce the risk of death in emergency.