Background Violence is a public health problem that keep affecting many countries around the world. Colombia, for many years has been immersed an armed conflict, and Mexico, in recent years, has been facing a critical situation associated with drug traffics. The objective was to analyze and compare patterns of mortality trends between Colombia and Mexico, between 2000–2015 years.

Methods A comparative longitudinal study is used, along with data provided by the National Statistics from both countries. Causes related to violent mortality were analyzed. A comparative analysis was made by country, year, age groups, cause and sex. Multivariate analysis was done by country as dependent variable adjusted for sex, age groups and mortality cause.

Findings There were 5 76 994 homicides, 55.6% of death occurred in Colombia: The main causes of death were firearms (Colombia:82%, Mexico:62%). Strangulation was bigger in Mexico (7.5%) compared to Colombia (1.5%). In 2000 the risk of violent death was six times higher in Colombia/Mexico, in 2015 it was reduced to 1.5 times. In Mexico between 2006–2011 there was an increase of up to 150% in mortality due to this cause. The most affected victims have been men in productive age, where the death was caused by firearm and by sharp weapons.

Conclusions and policy implications The increase of violent mortality in Mexico has been related to the fight against different drug traffics groups and others outside the law; in this country, homicides suggest more suffering. In Colombia, it seems that public policy measures, such as the restriction on carrying illegal weapons and security policies, introduced in 2003, generating declines in mortality violent. Both countries need to professionalize their police forces; they must continue working to diminish the circles of impunity, corruption, weaknesses of the justice system, lack of authority, and to strengthen the presence of the state in marginalized regions.