Save the Children, BASICS I, and the Guinea MOH conducted a study of mortality among children less than 5 years old in Mandiana, Guinea, from October 1998 through September 1999. This report describes the results of a verbal and social autopsy that was used to investigate the deaths of 330 children under 5. The objectives of the study were to determine (1) causes and trends in mortality, (2) the relative importance of each step in the Pathway to Survival, and (3) the most appropriate interventions to reduce child mortality in Mandiana and other similar settings. The methodology for the study built upon tools and methods developed by BASICS and Johns Hopkins University