Background Violent death has been a public health issue in the Americas. In the past few years, this problem has decreased in Colombia, as opposed to the situation in Mexico. This paper aims to analyse and compare violent death patterns and trends in Colombia and in Mexico from 2000 to 2012.

Methods This comparative, longitudinal study used secondary data furnished by the national agencies in charge of recording, processing, and analysing vital statistics in each of the two countries. The causes of violent death recorded in the International Classification of Diseases were analysed. A comparative analysis of cause of death using the variables country, year, age group, cause, sex, and religion was made, obtaining proportions. A multivariate analysis was made using the dependent variable “country”, and the independent variables “sex”, “age group”, and “cause”.

Results From 2000 to 2012, there were 472,658 violent deaths in both countries: 59.2% in Colombia and 40.8% in México. At the beginning of the period under study, the risk of violent death was six times higher in Colombia than in Mexico; at the end of the period under study, such risk decreased to 1.6 times higher in Colombia than in Mexico. The most affected population is men of working age; the risk of death includes death by firearms and death by sharp weapons.

Conclusions Violent death decreased in Colombia and increased in Mexico during the period under study. However, the risk of violent death is still higher in Colombia than in Mexico. The increase in violent deaths in Mexico is related to the fight against drug trafficking in its different forms, to criminal gangs, and to outlawed groups. In Mexico, the causes of death suggest greater suffering.