Objective To understand the distribution characteristics of inpatient deaths in a hospital, find out the cause of the changing trend of inpatient death rate, and provide reference for hospital management and area public health service. Methods The data on first pages of medical records were collected in a tertiary hospital from 2010 to 2019, and death causes were classified according to the classification criteria of ICD-10. The cross-table analysis, chi-square test and correlation analysis were used to analyze the basic information about patients, the rank of death causes, the changing of inpatient mortality. Results Cancer and cardiovascular disease were the top two causes of death for both men and women. The nosocomial mortality had been falling in the last decade. This falling had an intense relationship with decrease in quantities of cardiovascular disease and tumor. The deaths from respiratory diseases in men were on the rise. Conclusion Hospitals should pay more attention to the prevention, diagnosis, treatment about tumor, cardiovascular disease and respiratory diseases to reduce the incidence and mortality of these diseases and improve the qualify of life.