The objective of this study was to investigate the relationship between household structure and mortality at older ages in Parma, Italy. The household is an important setting for older people's social roles and social relations and its composition has a strong association with their health. The study examines 57,830 people aged 65 or more years drawn from the population registers of Parma (Italy). Record linkage from 1989 to 2000 was carried out using their unique identification numbers. Through the linked records, it was possible to follow changes in each person's and family's history provided they remained resident in Parma. The descriptive analyses show that elderly women were more likely than men to live alone, probably on account of their higher longevity. Only 10 per cent of elderly men lived alone, as compared with 32 per cent of older women. Nonetheless, the survival curves demonstrate that up to the age of 80 years, women living alone experienced lower mortality than those living with partners. A logistic regression model based on ‘event history analysis’ was performed using the longitudinal data. The results suggest that being married provides a protective role against mortality in later life only for men. It is possible that elderly women who take care of a husband or relatives do not care for themselves (or their health), as do older women who live alone.