This is the first analysis of the evolution of major causes of death in the canton of Geneva during the twentieth century. Data was abstracted from handwritten archives of the Federal Office for Statistics. Life expectancy has increased during the century for men and women. There has been a steady decline of the epidemic of tuberculosis during this century. Other epidemics, such as coronary heart disease or lung cancer in males, started during the twentieth century but seem to have already reached a peak. A third group of epidemics such as AIDS or lung cancer in women are still increasing. In the future, surveillance of causes of death should be supplemented with surveillance of exposure to risk factors for these diseases.