A total of 53 in-custody deaths that occurred in Atlanta-Fulton County, Georgia, between 1974 and 1985 are reviewed. Custody deaths showed characteristics similar to those described in other geographical areas. The majority of deaths were due to natural causes, about one-fourth were suicides, and homicides were rare. For jails that housed a daily population of about 1,000 prisoners, an average of 4.4 deaths were observed annually. Men predominated, and racial makeup paralleled the general prison population. Seizures, alcohol-related illness, and cardiovascular disease caused over half of the natural deaths. All suicides were accomplished by hanging. Over two-thirds of the incidents that led to death occurred in the prisoner's cell, and about one-half of the victims were found dead in their cells. Two-thirds of those who died in custody had been arrested for crimes in which persons were not harmed, while nearly two-thirds of those committing suicide had been arrested for crimes against persons. Deaths in custody are expected events, and familiarity with the circumstances under which they occur should be helpful in enabling prison managers to establish policies and procedures to minimize their occurrence.