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The paper examines mortality patterns in the city of Hermoupolis, on the Greek island of Syros, from 1859 to 1940. It produces important new insights into Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece, utilising the largest and one of the longest time series at the individual level yet calculated from civil registration and census data. Abridged life tables were constructed for the first time for a Greek urban settlement, enabling the calculation of age-specific mortality rates and life expectancies. Hermoupolis experienced much higher mortality levels than the national average. The findings suggest that early childhood mortality started to decline rapidly from the late nineteenth century onwards, with declines in early adulthood and infancy following. The paper reinforces and confirms our limited knowledge about the timing of the mortality transition in Greece. It proposes that an urban penalty was clearly operating in the country even during the early twentieth century. Finally, this paper suggests that a combination of factors was responsible for the mortality decline in Hermoupolis, including wider access to water, which even when it was not clean enough to drink, nevertheless enabled improvements in personal hygiene among the residents of the city.