The aim of this study is to analyze levels, trend and seasonal patterns of under-5 mortality in Alexandria. In order to fulfill this aim, a retrospective study is conducted to collect recorded data about under-5 deaths and live births from 1996 to 2001 from Health Information Center and CAPMAS in Alexandria. Causes of death are categorized using the ICD-10. Several trend equations were tried to select the best fit trend equation. Seasonality is tested using the 12-month moving average method. The predicted value for under-5 mortality rates for the year 2002 is calculated using the best-fit trend equation and the seasonal index and compared to the actual levels to test the validity of the prediction models. The study revealed a significant downward trend of U5MR PNMR and CMR while the NMR does not show significant decrease over the study period. The peak seasonal index of U5MR is in December followed by summer months, those of NMR and CMR are in summer and PNMR is mainly in winter. Maximum index of U5MR due to ARI is in winter while rates related to congenital malformations are in autumn while deaths due to perinatal conditions are mainly in May and June, and external causes of injury are mainly in summer. Though the picture is promising special emphasis is still needed for ARI, congenital anomalies and perinatal conditions.