Introduction - Since 2007, a new electronic death certification system has been available to physicians. This study represents the first epidemiological analysis of the data collected through this system. Methods - The progress of the rollout of electronic certification was assessed from January 2007 to September 2011. A comparative analysis of deaths by age, sex, department, and medical cause of death according to the method of certification (paper/electronic) was conducted for the year 2010. The use of data for real-time health surveillance is illustrated using the example of influenza. Results - In June 2011, nearly 5% of national mortality was certified electronically, with a heterogeneous distribution by department. Eighty-four percent (84%) of electronic certificates were recorded at the hospital (vs. 48% for paper certificates). Deaths of individuals aged 85 and older were the least frequently certified electronically. Ninety percent (90%) of deaths were certified within one day of the death. Conclusion - Available to epidemiologists within hours of death, data from electronic certification represent a significant improvement for public health surveillance. However, using this system for reliable surveillance at the national level requires strong participation from healthcare facilities. (R.A.)