Though once viewed as ailments of the affluent, deaths related to non-communicable diseases (NCDs) now account for more than double the deaths caused by infectious disease worldwide (PAHO 2002) with steadily increasing figures in developing countries. The Caribbean is not exempt from this phenomenon, rather, we are quite an extreme example of it as age standardized mortality rates of non-communicable disease in the region often exceed the data seen almost anywhere else. This presentation will focus on four territories (Barbados, Guyana, Jamaica, Trinidad and Tobago) and will highlight the mortality rates associated with the four major NCDs in the region: coronary heart disease, prostate cancer, stroke and diabetes mellitus.