There have been marked disparities in mortality between metropolitan French départements for the past thirty years. They have lessened for women but remain high for men. As in the 1960s, the worst placed regions are the North, Alsace and Brittany. Mortality is lower in Paris, the south-western départements of Île-de-France, and Rhône-Alpes and Midi-Pyrénées (mainly for men); the lowest female mortality is found in the north of Poitou-Charentes and in Pays de la Loire. Geographical variations in life expectancy at birth are closely linked to variations in mortality above age 30, especially at ages 60-79, but not systematically with variations in child mortality. At ages 30-60, cancers remain the prime explanation (particularly lung cancer for men), together with alcoholism and suicide, which also impact the higher age groups. Cancers still account for a large share of mortality inequalities at ages 60-80, along with cardiovascular diseases, for women especially. After age 80, these diseases account for 50% of mortality variation between départements for women and 40% for men.