Inaccuracy of the cause of death certification can impair the national health database and the medico-legal investigations. This study aimed to assess the errors of medical certification of cause of death at Benha University Hospitals, Egypt, to suggest necessary corrective measures. Death notification forms (DNFs) of all patients (n=347) who had expired during the period from January 2014 to December 2014 were assessed. The demographic characteristics, administrative details and the medical certification of the cause of death were reviewed using an approved standardized form. Errors in the DNFs were classified into six categories, from 0 to V according to increasing severity of errors. The study recorded errors in 100% of DNFs. The high proportion (63.4%) of DNFs contained major errors (grade V), sufficiently serious to affect the accuracy and interpretation of the medical certification of the cause of death. There was an obvious confusion between the underlying cause of death and the mode of death in most (61.1%) of DNFs. The results of this study underscore the usefulness of the format database utilized by the ministry of health in Egypt. Educational, managerial and administrative interventions are urgently needed to improve the standard of DNFs completion