To clarify the effect of environmental cadmium (Cd) exposure on the life prognosis of inhabitants living in a Cd-polluted area, the standardized mortality ratio (SMR) according to cause of death in urinary β 2-microglobulin (β2-MG)-positive subjects (≥1000 μg/gCr) was compared to that of the Japanese general population and β2-MG-negative subjects (β 1000 μg/gCr).The SMR for all causes of death of both sexes was higher than that of the Japanese general population and β 2-MG-negative subjects. Among women, the SMR for malignant neoplasms was higher than that of β 2-MG-negative subjects. For cardiovascular disease and cerebrovascular disease, especially heart failure and cerebral infarction, SMRs were significantly higher in both sexes. The SMR for renal diseases was significantly high in the men and tended to be high in the women.These results suggest that the prognosis of urinary β 2-MG-positive subjects with Cd-induced renal tubular dysfunction is unfavorable, with higher mortality rates due to renal diseases, cerebral infarction and heart failure contributing to this. Although the increase of the mortality rate was slight, Cd might affect cancer mortality in women.