Background: In the last decade, Chile achieved a significant reduction in poverty, however income distribution still shows inequalities. The richest 10% of the population perceived 46% of total income. Aim: To study the relationship between territorial socioeconomic segregation and adult mortality in the Metropolitan area of Santiago de Chile. Material and methods: Data from the 34 districts of Metropolitan Santiago were analyzed. Adjusted community mortality rates, during 2000, among adults aged 20 years or more, including specific rates per sex and age group, were analyzed. Results: There was a negative correlation between income and mortality, specially among men (rS -0.42 p <0.005). The highest correlation coefficient was observed among subjects aged 45-64 years old (rS -0.42 p <0.005). There was a high degree of inequality in mortality among males aged 20-44 years old (Gini 0.54) and in the age group 45-64 years old in both sexes (Gini 0.50). Mortality rates decreased along with increasing incomes in both sexes. 20/20 ratio shows the higher values for mortality of men aged 20-44 years (20/20 ratio 1.7 95% CI 1.4-2.0), followed by mortality of men aged 45-64 years. Conclusions: There is a relationship between economic segregation (expressed by income) and mortality. The higher mortality rates are observed in districts of Metropolitan Santiago with the lower income (Rev Méd Chile 2004; 132: 453-60)