A 100% sample of Medicare claims records of patients undergoing radical prostatectomy in 1990 was analyzed for 30-day mortality and 1-year all-cause mortality rates. Overall, there was a 0.5% 30-day mortality and 1.8% 1-year mortality rate. Compared to the general population, mortality was approximately half of expected mortality and close to estimated mortality of elderly men in excellent health. There was no trend of increasing 30-day mortality with patient age, and a modestly increased 1-year mortality rate with increasing age. These results are consistent with improved perioperative survival for all patients compared to analyses performed on data for prior years and selection of healthy patients undergoing radical prostatectomy. These trends improve the potential benefit of radical prostatectomy.