The first edition of the EC Atlas of Avoidable Death was published in 1988. It described mortality from 17 conditions in 10 countries in the period 1974-78. This second edition describes avoidable mortality between 1974-78 and 1980-84. Spain and Portugal are now included. There is growing interest in evaluating and monitoring health services. Progress in the development of indicators and the quality and outcome of health care has lagged behind that of measures of process and efficiency. The Atlas is an important step towards establishing outcome indicators to monitor health service performance that are applicable nationally and internationally. The conditions chosen were considered by all collaborating researchers to be relevant to all the EC member countries and to reflect important aspects of health care provision. The Atlas illustrates wide variation in mortality rates, but due to the complexity of the possible factors involved, no attempt has been made to interpret the patterns involved or to draw conclusions. It is hoped that the Atlas will stimulate countries to initiate detailed inquiries into the functioning of health services and should pave the way for future collaboration between health services researchers. This second edition allows the comparison of trends over time.