Key PointsQuestionIn the US from 1988-2018, were tropical cyclones associated with increases in county-level cause-specific death rates in subsequent months?FindingsIn this retrospective observational analysis that included 33.6 million deaths in 1206 counties that experienced tropical cyclones from 1988-2018, each additional cyclone day per month was associated with increases in monthly county-level death rates in the month following a cyclone for several causes of death including injuries (3.7%), infectious and parasitic diseases (1.8%), respiratory diseases (1.3%), cardiovascular diseases (1.2%), and neuropsychiatric conditions (1.2%) but not for cancers.MeaningAmong US counties that experienced at least 1 tropical cyclone from 1988-2018, each additional cyclone day per month was associated with modestly higher death rates in the months following the cyclone for several causes of death.