Background: Accurate and comparable good-quality data on mortality and causes of death regarding completeness, accuracy and timeliness should be enhanced to support policy development and implementation. Objective: to assess the quality (completeness and correctness) of registration of cause-of-death at home in Alexandria Health offices using WHO Verbal Autopsy tool. Method: Descriptive approach was selected where a cross sectional survey was conducted. Records of home deaths, in 24 months, were obtained from all health offices. Then, verification of the data registered was done by visiting homes of those deaths and conducting re-interviews with family members using “Verbal Autopsy" approach. The collected data was submitted to the assigned team of three independent doctors trained by WHO staff to identify the immediate and underlying probable causes of death. The identified probable cause of death was compared with what was registered in the death certificate for any discrepancy. Results: On comparing health office records to VA diagnoses, only 35% of health office records causes of death were compliant with VA based diagnoses. The diseases with high sensitivity (>75%) were acute ischemic heart diseases (93%), cerebral infarction (83%), cerebral atherosclerosis (80%) and hepatic failure. Moreover, the percentage of ill-defined causes of diseases was reduced from 34.7% to 13.5%. Conclusion: The use of standard VA methods adapted to Egypt enabled a plausible assessment of cause-specific mortality patterns and a substantial reduction of ill-defined diagnoses