OBJECTIVES: This study examines the relationship between birth-place and mortality from circulatory diseases among American Blacks. METHODS: All Black deaths from circulatory diseases (International Classification of Diseases, 9th Revision. codes 390 through 459) were extracted from the National Center for Health Statistics mortality detail files for 1979 through 1991. Age-specific and age-adjusted mortality rates with 95% confidence intervals were calculated for males and females for combinations of five regions of residence at birth and four regions of residence at death. RESULTS: Males had higher mortality rates from circulatory diseases than females in every regional combination of birthplace and residence at death. For both genders, the highest rates were for those who were born in the South but died in the Midwest; the lowest rates were for those who were born in the West but died in the South. Excess mortality for both Southern-born males and females begins at ages 25 through 44. CONCLUSIONS: There is a region-of-birth component that affects mortality risk from circulatory diseases regardless of gender or residence at time of death. We must examine how early life experiences affect the development of circulatory disorders.