Background: Investigations into mortality from malignant tumors were initiated in the 1970’s in Hebei Province, China, and especially for esophageal cancer the rates were high, Shexian county ranking in first place of the towns that were surveyed. Methods: Since the 1970’s, a register system for all causes of death has been in place. Data for the decades of the 1970’s, 1980’s, 1990’s and 2000’s century were here checked and analyzed by SPSS software. Result: From the decades of the 1970’s onward, the mortality rates of malignant tumors/100,000 were 272.0, 260.1, 211.7 and 180.1, respectively, with significant differences over time (x2 =240.5, P<0.001). The main malignant tumors were esophageal, gastric, liver, lung and cervix cancers. The sum of their percentages of all cancer deaths were 92.1% in the 1970’s, 91.6% in the 1980’s, 92.1% in the 1990’s and 93.9% in the 21st century. The sex ratios (male vs female) were 1.5, 1.5, 1.7 and 2.0 respectively, with an ascending trend. Mortality rates of malignant tumors increased with age, with an obvious geographic distribution. The highest mortality of malignant tumors was evident in the area where the Qingzhang and Zhuozhang rivers join. Conclusion: From 1970’s to the beginning of the 21st century, the mortality rate of malignant tumors has shown a declining trend. The main responsible cancers are in the esophagus, stomach, liver, and lung. Through great efforts for prevention, obvious decrease for esophageal cancer and cervix cancer has been achieved, but the mortality rate for gastric cancer remains high.