Differentiated thyroid carcinoma (DTC) usually has a good prognosis, but sometimes the course of the disease results in death. The aim of the present study was to assess the effect of some variables in time to death on fatal cases in our series. A total of 83 patients with DTC who died between 1958 and 1998 from differentiated thyroid cancer were retrospectively analyzed with respect to gender, age at diagnosis, histology, percentage of (131)I uptake by postoperative thyroid remnant, site of tumor growth, and its (131)I uptake, metastases and time to death. Univariate analysis revealed a significantly shorter time to death in local recurrence when comparing local lymph node metastases and distant metastases even if neither show (131)I uptake. Multivariate analysis revealed that age at diagnosis was the most important factor in conditioning the time to death. In conclusion, in those patients who died from DTC an older age at diagnosis and presence of local recurrence influenced the time to death independently of (131)I uptake.