This study takes in account all post operative deaths during the year 1990 in one surgical Professorial unit of Lille academic hospital (France). During this year, 1492 consecutive patients underwent surgery. The mean age of deceased patients was 63.7 years. 15 died after emergency procedure and 12 after elective surgery. Lastly 2 patients died without any operation. The most common condition encountered in those cases was oesophageal carcinoma, thereafter gastric or duodenal complicated peptic ulcer, and finally colonic carcinoma and diverticular disease. 13 patients had neoplasia (45%). From a critical point of view, 14 patients died after surgical indication or procedure of questionable legitimacy. The comparison with a similar study conducted five years ago and the analysis of these charts allow us to reaffirm some basic principles of surgery.